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NICKI SADEGHIPOUR
NPI 1710526942
Physician Assistant - Medical in Philadelphia, PA

Active since January 06, 2020PECOS Enrolled
3401 N BROAD ST, PHILADELPHIA, PA 19140(215) 707-2000 Get Directions Write a Review

NPPES record last updated: January 14, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 14, 2020, Jan 8, 2020 (2 updates tracked since 2020).

About Nicki Sadeghipour NPPES

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

NICKI SADEGHIPOUR (NPI 1710526942) is an individual medical provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MA061084) and active in the NPI registry since January 2020. She is enrolled in Medicare PECOS and maintains a secondary practice location in Philadelphia.

NPPES Registry Identity

NPI1710526942
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameNICKI SADEGHIPOUR
Location Address3401 N BROAD STPhiladelphia, PA 19140-5189
Mailing Address412 N Front St Unit 29Philadelphia, PA 19123-4238 · (267) 614-6269
Phone(215) 707-2000
Sole ProprietorYes
Enumeration DateJanuary 6, 2020
Last NPPES UpdateJanuary 14, 20202 updates tracked since enumeration
✔ NPI 1710526942 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in PA · MA061084
3401 N BROAD ST, Philadelphia, PA 19140
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Secondary Practice Location 1

Location 1412 N Front St Unit 29Philadelphia, PA 19123-4238 · Phone (267) 614-6269

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicki Sadeghipour is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

DR. JAMIE L. GARFIELD MD
Internal Medicine
3401 N BROAD ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 707-5864
ELIZABETH DIANE DAUER MD
Surgery
3401 N BROAD ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 707-3133
MARIA ESTHER ESCORCIA DE LEON M.D.
Internal Medicine
3401 N BROAD ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 707-1622
JEONGAE YOON M.D.
Anesthesiology
3401 N BROAD ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 707-3326
DR. SUSETE CARNEIRO M.D.
Surgery
3401 N BROAD ST
PHILADELPHIA, PA 19140
Philadelphia County (201) 317-3485
DR. SARAH DENISE FENERTY M.D.
Radiology (Diagnostic Radiology)
3401 N BROAD ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 707-7237
TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Radiology (Radiation Oncology)
3401 N BROAD ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 707-4233
EDUARDO DOMINGUEZ CASTILLO M.D.
Internal Medicine (Pulmonary Disease)
3401 N BROAD ST, 812 PARKINSON PAVILION
PHILADELPHIA, PA 19140
Philadelphia County (215) 707-5864

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 Nicki Sadeghipour's NPI number?

The NPI number for Nicki Sadeghipour is 1710526942. It was assigned to this individual provider in the NPPES registry on January 6, 2020.

Where is Nicki Sadeghipour located?

Nicki Sadeghipour practices at 3401 N Broad St, Philadelphia, PA 19140. The listed phone number is (215) 707-2000.

What is Nicki Sadeghipour's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Nicki Sadeghipour enrolled in Medicare?

Yes. Nicki Sadeghipour is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Nicki Sadeghipour was last updated on January 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.