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MR. IDAN AVIV WAKSMAN PA-C
NPI 1457991903
Physician Assistant in Philadelphia, PA

Active since January 13, 2020PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
3400 SPRUCE STREET, GROUND SILVERSTEIN BLDG, PHILADELPHIA, PA 19104(617) 633-6414 Get Directions Write a Review

NPPES record last updated: April 17, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Apr 17, 2026, Jul 26, 2021, Jan 24, 2020 and 1 more (4 updates tracked since 2020).

About Mr. Idan Aviv Waksman Pa-c NPPES

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

MR. IDAN AVIV WAKSMAN PA-C (NPI 1457991903) is an individual physician assistant in Philadelphia, Pennsylvania, licensed in Pennsylvania (MA061390) and active in the NPI registry since January 2020. He is enrolled in Medicare PECOS, is affiliated with Virtua Our Lady Of Lourdes Hospital, and maintains 5 additional practice locations.

NPPES Registry Identity

NPI1457991903
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. IDAN AVIV WAKSMANCredential: PA-C
Location Address3400 SPRUCE STREET, GROUND SILVERSTEIN BLDGPhiladelphia, PA 19104-4206
Mailing Address3400 Spruce Street, Ground Silverstein BldgPhiladelphia, PA 19104-4206 · (215) 662-6698 · Fax (215) 662-3953
Phone(617) 633-6414
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateJanuary 13, 2020
Last NPPES UpdateApril 17, 20264 updates tracked since enumeration
NPPES CertifiedApril 17, 2026
✔ NPI 1457991903 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Licenses✔ Licensed in PA · MA061390✔ Licensed in NJ · 25MP00556700
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
3400 SPRUCE STREET, Philadelphia, PA 19104
Open in Google Maps ↗

Secondary Practice Locations 5

Location 11600 Haddon AveCamden, NJ 08103-3101 · Phone (856) 757-3500
Location 2218 Sunset Rd Fl 5Willingboro, NJ 08046-1110 · Phone (609) 835-3056
Location 3175 Madison AveMount Holly, NJ 08060-2038 · Phone (609) 914-6000 · Fax (609) 914-6182
Location 490 Brick Rd Fl 3Marlton, NJ 08053-2177 · Phone (856) 355-6000 · Fax (856) 355-6731
Location 5100 Bowman Dr Lowr Level1Voorhees, NJ 08043-9612 · Phone (856) 247-3000 · Fax (856) 247-2597

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Idan Aviv Waksman Pa-c 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 ID5799112918
PECOS Enrollment IDI20200228001472
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.

Areas of Expertise CMS Part B claims

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.

Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
34 services34 patients

Hospital Affiliations CMS Care Compare 4

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

Virtua Our Lady Of Lourdes Hospital

Acute Care Hospitals · Camden, NJ
1/5 CMS rating
OwnershipGovernment - State
CMS Certification Number310029
Location1600 Haddon AvenueCamden, NJ 08103 · Camden County
Emergency services Birthing friendly

Hospital Of Univ Of Pennsylvania

Acute Care Hospitals · Philadelphia, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390111
Location34th & Spruce StsPhiladelphia, PA 19104 · Philadelphia County
Emergency services Birthing friendly

Penn Presbyterian Medical Center

Acute Care Hospitals · Philadelphia, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390223
Location51 North 39th StreetPhiladelphia, PA 19104 · Philadelphia County
Emergency services

Pennsylvania Hospital

Acute Care Hospitals · Philadelphia, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390226
Location800 Spruce StreetPhiladelphia, PA 19107 · Philadelphia County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19104 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
$92.69 typical visit price
range $59.88 – $180.99
Typical copayment $23.17 (range $14.97 – $45.24)
Most-billed visit code 99203
Established Patient
$74.47 typical visit price
range $19.30 – $147.29
Typical copayment $18.61 (range $4.82 – $36.82)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability100
Improvement Activities40

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.

SARAH KUMAR M.D.
Anesthesiology (Critical Care Medicine)
3400 SPRUCE STREET
PHILADELPHIA, PA 19104
Philadelphia County (215) 349-8310
RYAN MCCLINTOCK MD
Radiology (Diagnostic Radiology)
3400 SPRUCE STREET
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-3000
ADRIAN W ONG MD
Surgery (Surgical Critical Care)
3400 SPRUCE STREET, 2 DULLES
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-7320
MATHEW N BESHARA MD
Obstetrics & Gynecology
3400 SPRUCE STREET, 5 PENN TOWER
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-6035
JILL E LANGER MD
Radiology (Diagnostic Radiology)
3400 SPRUCE STREET, GROUND FLOOR DULLES
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-7012
BERNADETTE C WHEELER MD
Obstetrics & Gynecology
3400 SPRUCE STREET, 1 WEST GATES
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-2730
EDWARD T DICKINSON MD
Emergency Medicine
3400 SPRUCE STREET, GROUND SILVERSTEIN BLDG
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-6698
WENDY RACHEL GALPERN MD, PHD
Psychiatry & Neurology (Neurology)
3400 SPRUCE STREET
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-2219

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 Idan Waksman's NPI number?

The NPI number for Idan Waksman is 1457991903. It was assigned to this individual provider in the NPPES registry on January 13, 2020.

Where is Idan Waksman located?

Idan Waksman practices at 3400 Spruce Street Ground Silverstein Bldg, Philadelphia, PA 19104. The listed phone number is (617) 633-6414.

What is Idan Waksman's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Idan Waksman enrolled in Medicare?

Yes. Idan Waksman 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.

Is Idan Waksman affiliated with any hospitals?

According to CMS data, Idan Waksman is affiliated with Virtua Our Lady Of Lourdes Hospital, Hospital Of Univ Of Pennsylvania, Penn Presbyterian Medical Center and Pennsylvania Hospital.

When was this NPI record last updated?

The NPPES record for Idan Waksman was last updated on April 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.