BROAD STREET PROFESSIONAL MEDICAL SERVICES LLC
NPI 1720630650
Surgery - Vascular Surgery in Philadelphia, PA

Q: 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.

Active since July 11, 2019

2033 S BROAD ST STE A, PHILADELPHIA, PA 19148(215) 795-3855(224) 235-4652 Get Directions Write a Review

NPPES record last updated: July 11, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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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

NPI1720630650

Entity TypeOrganization

Primary Taxonomy2086S0129X

Legal Business NameBROAD STREET PROFESSIONAL MEDICAL SERVICES LLC

Location Address2033 S BROAD ST STE APhiladelphia, PA 19148-5505

Mailing AddressPo Box 302Northbrook, IL 60065-0302 · (847) 593-8460 · Fax (224) 235-4652

Phone(215) 795-3855

Fax(224) 235-4652

Organization SubpartNo

Authorized OfficialAmi AlmedaCredentialing Manager · (224) 318-0118

Enumeration DateJuly 11, 2019

✔ NPI 1720630650 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Vascular SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code2086S0129X

Definition

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

2033 S BROAD ST STE A, Philadelphia, PA 19148

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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.

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.