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DR. MICKY KYLER BACCHUS DO
NPI 1386574267
Student in an Organized Health Care Education/Training Program in Philadelphia, PA

Active since May 21, 2026
5501 OLD YORK RD STE 1, PHILADELPHIA, PA 19141(215) 456-7190 Get Directions Write a Review

NPPES record last updated: May 21, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Micky Kyler Bacchus Do NPPES

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

DR. MICKY KYLER BACCHUS DO (NPI 1386574267) is an individual student in an organized health care education/training program in Philadelphia, Pennsylvania and active in the NPI registry since May 2026.

NPPES Registry Identity

NPI1386574267
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDR. MICKY KYLER BACCHUSCredential: DO
Location Address5501 OLD YORK RD STE 1Philadelphia, PA 19141-3098
Mailing Address5501 Old York Rd Ste 1Philadelphia, PA 19141-3098
Phone(215) 456-7190
Sole ProprietorNo
Enumeration DateMay 21, 2026
NPPES CertifiedMay 21, 2026
✔ NPI 1386574267 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
5501 OLD YORK RD STE 1, Philadelphia, PA 19141
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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.

GREGORY JOHNSON MD
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD STE 1
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
DR. JULIE MINJU GANG DMD
Dentist (General Practice)
5501 OLD YORK RD STE 1
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7130
ALINE A IANNONI DE MORAES
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD STE 1
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-8520
DR. BRIANA M CALDERON PARKER MD
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD STE 1
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
ASHMIN SINGH
Internal Medicine
5501 OLD YORK RD STE 1
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-6629
ALEXANDER JAMES RAZIN MD
Internal Medicine
5501 OLD YORK RD STE 1
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-6500
NEETHU KANJINGAT NANDAN MBBS
Psychiatry & Neurology (Psychiatry)
5501 OLD YORK RD STE 1
PHILADELPHIA, PA 19141
Philadelphia County (215) 456-7890
EMILY ELIZABETH MESSINA
Student in an Organized Health Care Education/Training Program
5501 OLD YORK RD STE 1
PHILADELPHIA, PA 19141
Philadelphia County (215) 457-4444

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 Micky Bacchus's NPI number?

The NPI number for Micky Bacchus is 1386574267. It was assigned to this individual provider in the NPPES registry on May 21, 2026.

Where is Micky Bacchus located?

Micky Bacchus practices at 5501 Old York Rd Ste 1, Philadelphia, PA 19141. The listed phone number is (215) 456-7190.

What is Micky Bacchus's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Micky Bacchus was last updated on May 21, 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.