1. Home
  2. Directory
  3. Pennsylvania
  4. Philadelphia
  5. Internal Medicine
  6. NPI Profile

CARLY DEFARIA MD
NPI 1013533124
Internal Medicine in Philadelphia, PA

Active since June 24, 2020PECOS EnrolledAccepts Medicare Assignment
5501 OLD YORK RD, PHILADELPHIA, PA 19141(215) 456-7890 Get Directions Write a Review

NPPES record last updated: August 6, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 6, 2026, Oct 25, 2023, Jun 24, 2020 (3 updates tracked since 2020).

About Carly Defaria Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARLY DEFARIA MD (NPI 1013533124) is an individual internal medicine provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD482282) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS, is affiliated with Jefferson Health- Northeast, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1013533124
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameCARLY DEFARIACredential: MD
Location Address5501 OLD YORK RDPhiladelphia, PA 19141-3018
Mailing Address5501 Old York RdPhiladelphia, PA 19141-3018
Phone(215) 456-7890
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJune 24, 2020
Last NPPES UpdateAugust 6, 20263 updates tracked since enumeration
NPPES CertifiedAugust 6, 2026
✔ NPI 1013533124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in PA · MD482282✔ Licensed in VT · 042.0040559
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
5501 OLD YORK RD, Philadelphia, PA 19141
Open in Google Maps ↗

Secondary Practice Locations 3

Location 1111 Colchester AveBurlington, VT 05401-1473 · Phone (802) 847-7911
Location 2115 Porter DrMiddlebury, VT 05753-8629 · Phone (802) 388-4701
Location 3130 Fisher Rd Unit 1Berlin, VT 05602-8132 · Phone (802) 225-1743

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Carly Defaria Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7315301918
PECOS Enrollment IDI20230915000303
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

4

Medicare enrollment records show Carly Defaria reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Aria Health Physician Services - Juniata
2.9 mi
Family Medicine
1139 E LUZERNE ST
Philadelphia, PA 19124
  • Reassigned Medicare billing, Pennsylvania enrollment
  • Medicare enrollment name: Aria Health Physician Services
  • 490 clinicians in this Medicare group
NPI 1508991589 (215) 537-5094
Porter Hospital Inc
281 mi
Family Medicine
61 COURT DR, NESHOBE FAMILY MEDICINE
Brandon, VT 05733
  • Reassigned Medicare billing, Vermont enrollment
  • Also billed through NPI 1134457013 (Vermont)
  • 243 clinicians in this Medicare group
NPI 1609896935 (802) 247-3755
Central Vermont Medical Center Inc
318 mi
Family Medicine
130 FISHER RD
Berlin, VT 05602
  • Reassigned Medicare billing, Vermont enrollment
  • 562 clinicians in this Medicare group
NPI 1023028784 (802) 371-4100
University Of Vermont Medical Center Inc
322 mi
Internal Medicine
111 COLCHESTER AVE
Burlington, VT 05401
  • Reassigned Medicare billing, Vermont enrollment
  • 1,643 clinicians in this Medicare group
NPI 1659309615 (802) 847-0000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
347 services149 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
152 services69 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
101 services97 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
53 services51 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
22 services22 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Jefferson Health- Northeast

Acute Care Hospitals · Philadelphia, PA
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390115
Location10800 Knights RoadPhiladelphia, PA 19114 · Philadelphia County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19141 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KENNETH KLECKNER MD
Emergency Medicine
5501 OLD YORK RD, EINSTEIN MEDICAL CENTER - PHILADELPHIA
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-6679
MS. AMMAN HASSAN MD
Pediatrics
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-3810
TAYLOR NICOLE THOMPSON PA-C
Physician Assistant (Medical)
5501 OLD YORK RD, KORMAN BUILDING SUITE 202
PHILADELPHIA, PA 19141
Philadelphia County (215) 254-2630
STEPHEN RYAN CHEN
Orthopaedic Surgery
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
DR. DHRUV SHARMA MD
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
TIMOTHY DANIEL GARDNER DO
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
DR. JONATHAN THOMAS LUCIANI DO
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
ASHIKA KAPOOR MD
Psychiatry & Neurology (Psychiatry)
5501 OLD YORK RD
PHILA, PA 19141
Philadelphia County (215) 456-8103

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carly Defaria's NPI number?

The NPI number for Carly Defaria is 1013533124. It was assigned to this individual provider in the NPPES registry on June 24, 2020.

Where is Carly Defaria located?

Carly Defaria practices at 5501 Old York Rd, Philadelphia, PA 19141. The listed phone number is (215) 456-7890.

What is Carly Defaria's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Carly Defaria enrolled in Medicare?

Yes. Carly Defaria is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Carly Defaria's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carly Defaria reassigns Medicare benefits to 4 organizations: Aria Health Physician Services - Juniata (Philadelphia, PA), Porter Hospital Inc (Brandon, VT), Central Vermont Medical Center Inc (Berlin, VT) and University Of Vermont Medical Center Inc (Burlington, VT). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Carly Defaria's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Carly Defaria accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Carly Defaria as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Carly Defaria affiliated with any hospitals?

According to CMS data, Carly Defaria is affiliated with Jefferson Health- Northeast.

When was this NPI record last updated?

The NPPES record for Carly Defaria was last updated on August 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.