MOHAMAD KADKHODA (NPI# 1104802743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104802743 |
| Entity Type | Individual |
| Full Name | MOHAMAD KADKHODA |
| Credential | MD |
| Practice Address |
1300 W Lehigh Ave Suite B Philadelphia PA 19132-2701 |
| Mailing Address |
2450 W Hunting Park Ave Fl 2 Philadelphia PA 19129-1302 |
| Practice Telephone | 2152268800 |
| Practice Fax Number | 2152268819 |
| Mailing Telephone | 2159269022 |
| Mailing Fax Number | 2152268286 |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2020-01-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | MD034718L | PA | Allopathic & Osteopathic Physicians |
| Y | 208000000X | Pediatrics | MD 034718L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | INDEPENDENCE BLUE CROSS | 0055553000 | 01 |
| PA | 000692373 | 05 | |
| PA | AETNA HMO | 2098859 | 01 |
| PA | RR MEDICARE | P00025017 | 01 |
| PA | KMHP | 10021A | 01 |
| PA | HIGHMARK BLUE SHIELD | 114698 | 01 |
| PA | AETNA PPO | 5987421 | 01 |
| Street Address |
1300 W LEHIGH AVE SUITE B |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19132-2701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720082340 | Broad & Lehigh Pharmacy, Inc | Pharmacist | 1300 W Lehigh Ave, Suite 102, Philadelphia, PA 19132-2701 | 2005-06-10 |
| 1083005227 | The Dialysis Center of North Philadelphia LLC | Clinic/Center | 1300 W Lehigh Ave, Suite 106, Philadelphia, PA 19132-2760 | 2015-02-10 |
| 1467690420 | Anne Clark Mcfadden | Physician Assistant | 1300 W Lehigh Ave, Philadelphia, PA 19132-2701 | 2009-01-29 |
| 1598817520 | Temple Physicians Inc. | Pediatrics | 1300 W Lehigh Ave, Suite B, Philadelphia, PA 19132-2760 | 2007-01-18 |
| 1013068345 | Temple Physicians Inc. | Internal Medicine | 1300 W Lehigh Ave, Suite A, Philadelphia, PA 19132-2760 | 2007-01-15 |
| 1790769917 | Ronald Cowen | Family Medicine | 1300 W Lehigh Ave, Philadelphia, PA 19132-2701 | 2005-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811511017 | Irene Maria Clark | Social Worker | 3101 N. 29th St., Philadelphia, PA 19132 | 2020-06-03 |
| 1518407519 | Forget Me Knot Youth Services | Residential Treatment Facility, Emotionally Disturbed Children | 2321 N Broad Street, Philadelphia, PA 19132 | 2017-02-24 |
| 1609322437 | Shaakira Gillette | Social Worker | 2514 N. Broad St, Philadelphia, PA 19132 | 2016-08-31 |
| 1578017042 | Education Plus, Inc. | Nurse Practitioner | 3217 W. Clearfield Street, Philadelphia, PA 19132 | 2016-08-12 |
| 1972958544 | Rittenhouse Health LLC | Substance Abuse Rehabilitation Facility | 2321 N. Broad St, Philadelphia, PA 19132 | 2016-05-02 |
| 1336593458 | Jamal Vann | Counselor | 2233-43 West Allegheny Avenue, Philadelphia, PA 19132 | 2016-04-14 |
| 1487027132 | Jazzmin Devine | Specialist/Technologist | 200 Prospect St Hemlock 430a, East Stroudsburg University, PA 19132 | 2015-11-03 |
| 1609282508 | Lawrence Petitfrere | Pharmacist | 2801 W Dauphin St, Philadelphia, PA 19132 | 2014-07-11 |
| 1437565157 | Mental Health Partnerships | Community/Behavioral Health | 2709 N. Broad Street, Philadelphia, PA 19132 | 2014-07-02 |
| 1477977346 | Randy Morman | Counselor | 2514 N. Broad Street, 1st Floor, Philadelphia, PA 19132 | 2014-02-12 |
| Find all providers in zip 19132 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861036279 | Stc Pediatrics LLC | Pediatrics | 300 E Hunting Park Ave, Philadelphia, PA 19124-6018 | 2019-10-30 |
| 1447818729 | Elizabeth Edmondston Tarr | Pediatrics | 3401 Civic Center Blvd Fl 9nw55, Philadelphia, PA 19104-4319 | 2019-06-03 |
| 1245799337 | Jerry Martin Kaplan | Pediatrics | 2421 Fairmount Ave, Philadelphia, PA 19130-2517 | 2019-03-18 |
| 1992299861 | Gayathri Prabhakar | Pediatrics | 3401 Civic Center Blvd 9nw, Rm 55, Philadelphia, PA 19104-4319 | 2018-06-14 |
| 1992298004 | Daniel Rappoport | Pediatrics | 3401 Civic Center Boulevard, 9nw, Room 55, Philadelphia, PA 19104-4399 | 2018-06-13 |
| 1376069567 | Childrens Hospital of Philadelphia | Pediatrics | 3401 Civic Center Blvd Fl 4, Philadelphia, PA 19104-4319 | 2017-08-18 |
| 1558881581 | Isabel Cristina Castillo Hernandez | Pediatrics | 4500-10, Apt 201b, Philadelphia, PA 19124 | 2017-06-21 |
| 1891225694 | Joshua Hruby Sperling | Pediatrics | 3401 Civic Center Boulevard 9nw, Room 55, The Children's Hospital of Philadelphia, Philadelphia, PA 19104-4399 | 2017-06-14 |
| 1124558911 | Salvatore Charles Rametta | Pediatrics | 3401 Civic Center Boulevard Building 9nw Room 55, Children's Hospital of Philadelphia, Philadelphia, PA 19104 | 2017-06-14 |
| 1922536952 | Alyssa Coffin | Pediatrics | 3401 Civic Center Blvd Fl 9nw, Philadelphia, PA 19104-4319 | 2017-06-03 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19132 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.