BROAD STREET PROFESSIONAL MEDICAL SERVICES LLC
NPI 1720630650
Surgery - Vascular Surgery in Philadelphia, PA
About Broad Street Professional Medical Services Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BROAD STREET PROFESSIONAL MEDICAL SERVICES LLC (NPI 1720630650) is a healthcare organization registered as a vascular surgery in Philadelphia, Pennsylvania and active in the NPI registry since July 2019. The organization lists Ami Almeda, Credentialing Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Broad Street Professional Medical Services Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Broad Street Professional Medical Services LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Broad Street Professional Medical Services LLC's NPI number?
The NPI number for Broad Street Professional Medical Services LLC is 1720630650. It was assigned to this organization in the NPPES registry on July 11, 2019.
Where is Broad Street Professional Medical Services LLC located?
Broad Street Professional Medical Services LLC is located at 2033 S Broad St Ste A, Philadelphia, PA 19148. The listed phone number is (215) 795-3855.
What is Broad Street Professional Medical Services LLC's specialty?
The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.
Is Broad Street Professional Medical Services LLC enrolled in Medicare?
Yes. Broad Street Professional Medical Services LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Broad Street Professional Medical Services LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Broad Street Professional Medical Services LLC, in Family Practice, General Surgery, Interventional Radiology and Vascular Surgery. A 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 the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Broad Street Professional Medical Services LLC accept?
Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Broad Street Professional Medical Services LLC 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.
When was this NPI record last updated?
The NPPES record for Broad Street Professional Medical Services LLC was last updated on July 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Broad Street Professional Medical Services Llc · NPI 1720630650
Vascular Surgery organization in Philadelphia, Pennsylvania. Organization record, active in the CMS NPPES registry since July 11, 2019.
## Identity
- **NPI:** 1720630650 (Entity type: Organization)
- **Enumerated:** July 11, 2019
- **Primary specialty:** Surgery - Vascular Surgery · taxonomy 2086S0129X
- **Organization subpart:** No
- **Authorized official:** Ami Almeda, CREDENTIALING MANAGER
## Practice location
- **Address:** 2033 S BROAD ST STE A, Philadelphia, PA 19148-5505
- **Phone:** (215) 795-3855 · **Fax:** (224) 235-4652
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (1), General Surgery (1), Interventional Radiology (1); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 11, 2019
---
Source: [NPI Profile](https://npiprofile.com/npi/1720630650) · Data from the CMS NPPES public registry.