KELLY WADE MD NPI 1811924723

NPI Information

NPI: 1811924723
Provider Name: KELLY WADE, MD
Classification: Pediatrics - 2080N0001X
Entity Type: Individual

Specialization: Neonatal-Perinatal Medicine

PECOS Registration: Yes

Address:
3401 CIVIC CENTER BLVD
CHILDREN'S HOSPITAL OF PHILADELPHIA - NEONATOLOGY
PHILADELPHIA, PA
ZIP 19104
Phone: (215) 590-1944
Get Directions

Kelly Wade, MD is a neonatal-perinatal medicine pediatrics in Philadelphia, PA. The provider is a pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. Kelly Wade, MD NPI is 1811924723. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3401 CIVIC CENTER BLVD
CHILDREN'S HOSPITAL OF PHILADELPHIA - NEONATOLOGY
PHILADELPHIA, PA
ZIP 19104-319
Phone: (215) 590-1944
Fax: (215) 590-4454

The NPI 1811924723 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/27/2006 and was last updated on 4/17/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		MD073505L	PENNSYLVANIA	No
2	2080N0001X	Pediatrics	Neonatal-Perinatal Medicine	MD073505L	PENNSYLVANIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	0032905	MEDICAID	NEW JERSEY
2	1010911740001	MEDICAID	PENNSYLVANIA
3	078502	MEDICARE ID-TYPE UNSPECIFIED	PENNSYLVANIA
4	I05206	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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