PLASTIC/RECON ASSOC OF FCCC, MGI
NPI 1083988166
Surgery - Plastic and Reconstructive Surgery in Philadelphia, PA
NPI Status: Active since March 07, 2012
Contact Information
333 COTTMAN AVE
FOX CHASE CANCER CENTER
PHILADELPHIA, PA
ZIP 19111
Phone: (215) 728-6900
Fax: (215) 728-5507
- Organization
- Surgery
- Plastic and Reconstructive Surgery
- CLIA Number: 39D2297562
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-17-2028
About PLASTIC/RECON ASSOC OF FCCC, MGI
This page provides the complete NPI Profile along with additional information for Plastic/recon Assoc Of Fccc, Mgi, a provider established in Philadelphia, Pennsylvania operating as a Surgery, focusing in plastic and reconstructive surgery . The healthcare provider is registered in the NPI registry with number 1083988166 assigned on March 2012. The practitioner's primary taxonomy code is 2086S0122X. The provider is registered as an organization and their NPI record was last updated 8 years ago. Plastic/recon Assoc Of Fccc, Mgi operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Plastic/recon Assoc Of Fccc, Mgi. The authorized official of this NPI record is Tonya Woodard (Credentialing/manager)
- NPI
- 1083988166
- Provider Legal Name
- FOX CHASE CANCER CENTER MEDICAL GROUP, INC
- Other Organization Name
- PLASTIC/RECON ASSOC OF FCCC, MGI
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 333 COTTMAN AVE FOX CHASE CANCER CENTER PHILADELPHIA, PA 19111
- Location Phone
- (215) 728-6900
- Location Fax
- (215) 728-5507
- Mailing Address
- 2450 W HUNTING PARK AVE PHILADELPHIA, PA 19129
- Mailing Phone
- (215) 728-6900
- Mailing Fax
- (215) 728-5507
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-07-2012
- Last Update Date
- 06-14-2018
- Code Navigator
Location Map
Secondary Locations
- 2701 Dekalb Pike
Norristown, PA 19401
(888) 369-2487 - 2365 Heritage Center Dr
Furlong, PA 18925
(215) 782-6900
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Surgery Plastic and Reconstructive Surgery
- Taxonomy Code
- 2086S0122X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A surgeon who specializes in plastic and reconstructive surgery.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 208200000X | Allopathic & Osteopathic Physicians | Plastic Surgery |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1026888280029 | MEDICAID (05) | PA | |
| 1026888280037 | MEDICAID (05) | PA | |
| 1026888280019 | MEDICAID (05) | PA |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 39D2297562
- Facility Type
- Physician Office
- Certificate Effective Date
- January 18, 2026
- Certificate Expiration Date
- January 17, 2028
- Laboratory Director
- DR. ALEXANDER KUTIKOV
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Plastic/recon Assoc Of Fccc, Mgi to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for PLASTIC/RECON ASSOC OF FCCC, MGI
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1083988166, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 64 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
PHILADELPHIA, PA 19111
PHILADELPHIA, PA 19111
PHILADELPHIA, PA 19111
PHILADELPHIA, PA 19111
PHILADELPHIA, PA 19111
PHILADELPHIA, PA 19111
PHILADELPHIA, PA 19111
PHILADELPHIA, PA 19111
PHILADELPHIA, PA 19111
PHILADELPHIA, PA 19111
PHILADELPHIA, PA 19111
PHILADELPHIA, PA 19111
PHILADELPHIA, PA 19111
PHILADELPHIA, PA 19111
PHILADELPHIA, PA 19111
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1083988166, enumerated as an "organization" on March 07, 2012.
The provider is located at 333 COTTMAN AVE FOX CHASE CANCER CENTER PHILADELPHIA, PA 19111 and the phone number is (215) 728-6900.
Surgery with taxonomy code 2086S0122X and a focus in Plastic and Reconstructive Surgery.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
