Unknown Individual – Sports Medicine (Internal Medicine) Physician, NPI 1730129792
Sports Medicine (Internal Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
1 Bartol Ave
SUITE 100
Ridley Park, PA 190782214
Phone: (610) 521-8970
Fax: (610) 521-3983
Type: Location
510 Darby Rd
Havertown, PA 190834639
Phone: (610) 449-6499
Type: Location
Bartol Avenue, Leedom Estates, Ridley Park, Delaware County, Pennsylvania, 19078, United States
SUITE 100
RIDLEY PARK, PA 190782214
Phone: (610) 521-8970
Fax: (610) 521-3983
Type: Mailing
PO BOX 5228
WEST CHESTER, PA 193800405
Phone: (610) 355-5671
Fax: (610) 359-1519
Type: Mailing
200 E STATE ST STE 108
MEDIA, PA 190633434
Phone: (610) 876-0347
Fax: (610) 359-1519
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $117.
Total Amount is formed as General ($117) + Research ($0) + Ownership ($0) = $117.
Last reported payment date: 2023-09-13 • Largest payer in this snapshot: Zimmer Biomet Holdings, Inc. ($117).
Total Amount
$117
General + Research + Ownership
Payments
3
Total payment records
General Amount
$117
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-09-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Zimmer Biomet Holdings, Inc. | $117 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 88 | 83 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 79 | 79 | $0 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 79 | 43 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 46 | 45 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 19 | 19 | $0 |
Insurance plans in this area (ZIP 19078)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| INTERNAL MEDICINE | PA | 73630 | X-ray of foot, minimum of 3 views | 20 | 17 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | PA | |
| Diagnostic Radiology | IN | |
| - | PA | |
| - | PA | |
| Physical Therapist In Private Practice | PA | |
| Orthopedic Surgery | PA | |
| P O D I A T R Y | DE | |
| - | PA | |
| - | PA | |
| Orthopedic Surgery | PA |
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