Individual provider Active NPI

Nicholas S. Cavallaro, MD

  • Hospitalist Physician
  • Philadelphia, PA
National Provider Identifier
1942465950
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD442218 Issued in PA
Practice address
2301 S. Broad Street
2ND Floor
Philadelphia, PA 19148
Phone
(215) 952-9434
NPI assigned
Jul 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD442053 PA
Internal Medicine Physician 207R00000X MT193006 PA
Hospitalist Physician 208M00000X MD442218 PA Primary

Addresses

Primary practice location

2301 S. Broad Street
2ND Floor
Philadelphia, PA 19148

Mailing address

2301 S. Broad Street
2ND Floor
Philadelphia, PA 19148
Phone (215) 952-9434

Other identifiers 1

IdentifierTypeStateIssuer
102596637MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110505000257 PA Practitioner - Internal Medicine 3072798149 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Temple University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2301 S Broad St
Philadelphia, PA 19148-3542
Phone (215) 952-9936

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD442053PAMDInternal Medicine Physician
MT193006PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc CurrentSince Aug 6, 2012 Accepting new patients
Aria Health Physician Services CurrentSince Aug 1, 2019 Accepting new patients
Methodist Associates in Healthcare, Inc Internal Medicine CurrentSince Aug 6, 2012 Accepting new patients
Aria Health Physician Services CurrentSince Aug 1, 2019 Accepting new patients
Aria Health Physician Services Current Accepting new patients
Health Services of Fox Chase Cancer Center Past Accepting new patients
Health Services of Fox Chase Cancer Center Past Accepting new patients
Methodist Hospital Past Accepting new patients
Thomas Jefferson University Hospitals Inc Past Accepting new patients

Locations

2301 S Broad St
Philadelphia, PA 19148
Phone (215) 952-9000

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

10800 Knights Rd
Philadelphia, PA 19114
Phone (215) 612-2610

4900 Frankford Ave
Philadelphia, PA 19124
Phone (215) 612-2610

2301 S Broad St
Fl 2
Philadelphia, PA 19148
Phone (215) 952-9148

3998 Red Lion Rd
Philadelphia, PA 19114
Phone (215) 612-4060

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1942465950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 S. BROAD STREET",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19148",
            "telephone_number": "215-952-9434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 S. BROAD STREET",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19148",
            "telephone_number": "215-952-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVALLARO",
        "first_name": "NICHOLAS",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-20",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD442053",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT193006",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD442218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102596637",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.