Individual provider Active NPI

Mica Natasha Winchester, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1982133195
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD470815 Issued in PA
Practice address
2101 W Lehigh Ave Ste a
Philadelphia, PA 19132-2664
Phone
(267) 866-7211
Fax
(267) 202-7398
NPI assigned
Jun 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD470815 PA Primary

Addresses

Primary practice location

2101 W Lehigh Ave Ste a
Philadelphia, PA 19132-2664

Mailing address

2101 W Lehigh Ave Ste a
Philadelphia, PA 19132-2664
Phone (267) 866-7211

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
I20200707001589 PA Practitioner - Internal Medicine 8325316573 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Pennsylvania Holding, LLC Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
Dedicated Pennsylvania Holding, LLC Internal Medicine Current Accepting new patients
Dedicated Pennsylvania Holding, LLC CurrentSince Jul 1, 2020 Accepting new patients
Dedicated Pennsylvania Holding, LLC Internal Medicine Past Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

2101 W Lehigh Ave
Ste A
Philadelphia, PA 19132
Phone (267) 866-7211

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1982133195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 W LEHIGH AVE STE A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191322664",
            "telephone_number": "267-866-7211",
            "fax_number": "267-202-7398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 W LEHIGH AVE STE A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191322664",
            "telephone_number": "267-866-7211",
            "fax_number": "267-202-7398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINCHESTER",
        "first_name": "MICA",
        "middle_name": "NATASHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-09",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD470815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.