BRAVO HEALTH ADVANCED CARE CENTER, P.C. (NPI# 1265674592) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265674592 |
| Entity Type | Organization |
| Organization Name | BRAVO HEALTH ADVANCED CARE CENTER, P.C. |
| Practice Address |
1601 Chestnut St Philadelphia PA 19192-4071 |
| Mailing Address |
1500 Spring Garden St Ste 800 Philadelphia PA 19130-4071 |
| Practice Telephone | 2672385825 |
| Practice Fax Number | 8558035322 |
| Mailing Telephone | 2672385825 |
| Mailing Fax Number | 8558035322 |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2019-12-03 |
| Authorized Official Name | DIRK WALES (PRESIDENT) |
| Authorized Official Telephone | 6152366100 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
MD038974E | PA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1500 Spring Garden St Ste 800, Philadelphia, PA 191304071 | 2672385825 | 8558033522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902158678 | Bravo Health Advanced Care Center, P.C. | Family Medicine | 312 Martin Luther King Jr Blvd, Baltimore, MD 21201-1221 | 2012-10-05 |
| Street Address |
1601 CHESTNUT ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19192-4071 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053566588 | Connecticut General Life Insurance Company (cglic) | Clinic/Center | 1601 Chestnut St, Tl04b, Philadelphia, PA 19192-0003 | 2008-11-25 |
| 1700328960 | Shardell Elyn Moore | Nurse Practitioner | 1601 Chestnut St, Philadelphia, PA 19192-0003 | 2016-11-04 |
| 1033542527 | Christina Stasiuk | Internal Medicine | 1601 Chestnut St, 2 Liberty Place Tl08f, Philadelphia, PA 19192-0003 | 2013-08-20 |
| 1740541713 | Eileen A Sytnyk | Nurse Practitioner | 1601 Chestnut St, Tl04b, Philadelphia, PA 19192-0003 | 2012-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003855008 | Barton G Margoshes | Internal Medicine | Cigna, 1601 Chestnut St. Tl 24d, Philadelphia, PA 19192-0001 | 2006-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356942007 | Mpath Assistive Care LLC. | Homemaker | 243 E Walnut Park Dr, Philadelphia, PA 19120-1038 | 2020-11-07 |
| 1063013704 | Truong Vu | Pharmacist | 1675 Christopher Columbus Blvd, Philadelphia, PA 19148-1402 | 2020-11-07 |
| 1679174585 | Reputable Solutions Homecare LLC | Home Health | 1005 E Price St, Philadelphia, PA 19138-1806 | 2020-11-06 |
| 1205437233 | Joseph O Ampong | Registered Nurse | 1037 Magee Ave, Philadelphia, PA 19111-4815 | 2020-11-05 |
| 1649871658 | Yawei Song | Social Worker | 1101 Market St Ste 21000, Philadelphia, PA 19107-2934 | 2020-11-05 |
| 1962003160 | Hearts That Matter Most,llc | Clinic/Center | 1515 E Wadsworth Ave, Philadelphia, PA 19150-1620 | 2020-11-04 |
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1215538657 | Noel Mitchell | Social Worker | 410 Memphis St, Philadelphia, PA 19125-2642 | 2020-11-03 |
| 1326649799 | Joined Hands Homecare LLC | Home Health | 3728 Lankenau Rd, Philadelphia, PA 19131-2817 | 2020-11-03 |
| 1225639594 | Williamina Lebaga | Home Health Aide | 4032 Markland St, Philadelphia, PA 19124-5330 | 2020-11-03 |
| Find all providers in PHILADELPHIA | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801378740 | Temple Faculty Practice Plan Inc | Family Medicine | 3322 Broad St, Philadelphia, PA 19140-5103 | 2018-09-06 |
| 1043232531 | Barry L Marks | Family Medicine | 6302 Morton St, Philadelphia, PA 19144 | 2006-07-24 |
| 1356302715 | Patrick Timothy Waters | Family Medicine | 2101 W Lehigh Ave Ste A, Philadelphia, PA 19132-2664 | 2006-03-28 |
| 1841833548 | Tower Drexel Academic Medical Group LLC | Family Medicine | 10 Shurs Ln Ste 203, Philadelphia, PA 19127-2123 | 2019-10-25 |
| 1164879862 | Hishen Dang | Family Medicine | 3615 Chestnut St, Philadelphia, PA 19104-2612 | 2016-05-23 |
| 1326492570 | Michael Lawrence Weissberger | Family Medicine | 833 Chestnut St, Suite 301, Philadelphia, PA 19107-4414 | 2016-04-14 |
| 1033575352 | Methodist Associates In Healthcare, Inc. | Family Medicine | 2301 S Broad St, Philadelphia, PA 19148-3542 | 2016-01-04 |
| 1104205400 | Residentialist Housecall Med Grp, PC A Pennsylvania Corp | Family Medicine | 4190 City Ave, Pcom - Rowland Hall, Room 528, Philadelphia, PA 19131-1626 | 2015-05-20 |
| 1548689581 | Elizabeth Collins | Family Medicine | 833 Chestnut St, Suite 301, Philadelphia, PA 19107-4414 | 2014-04-07 |
| 1285959510 | Aroonsiri Howell | Family Medicine | 3322 N Broad St, Philadelphia, PA 19140 | 2010-03-30 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19192 |
Please comment or provide details below to improve the information on BRAVO HEALTH ADVANCED CARE CENTER, P.C..
| 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.