MEDICARE: PHILADELPHIA SURGICAL, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician
2	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1225977267
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHILADELPHIA SURGICAL, LLC

Provider Business Mailing Address
First Line	:	8400 ROOSEVELT BLVD # 100
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-2081
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8400 ROOSEVELT BLVD # 100
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-2081
Country	:	US
Telephone Number	:	111-111-1111
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. ALEXANDER INGRAM
Credential	:
Telephone Number	:	267-455-4855

Provider Enumeration Date	:	03/26/2026
Last Update Date	:	03/31/2026

Similar Medicare Providers

1619953361 — DR. JEFFREY S. GRAND PSY.D.
Practice Location Address:

8400 ROOSEVELT BLVD STE 206
PHILADELPHIA, PA
19152-2081

Practice Phone: 215-901-8791
Practice Fax: 215-333-7563

1457319550 — DR. KENNETH M LEVY DO
Practice Location Address:

8400 ROOSEVELT BLVD , STE 206
PHILADELPHIA, PA
19152-2081

Practice Phone: 215-333-7560
Practice Fax: 215-333-7563

1376580902 — DR. ARMAND FORMICA DO
Practice Location Address:

8400 ROOSEVELT BLVD , SUITE 220
PHILADELPHIA, PA
19152-2081

Practice Phone: 215-831-1017
Practice Fax: 856-424-6065

1225069156 — DR. JAN A OLENGINSKI D.O.
Practice Location Address:

8400 ROOSEVELT BLVD , SUITE 220
PHILADELPHIA, PA
19152-2081

Practice Phone: 215-331-7001
Practice Fax: 215-331-7004

1033267463 — GENERAL & VASCULAR SURGICAL GROUP, P.C
Practice Location Address:

8400 ROOSEVELT BLVD , SUITE 220
PHILADELPHIA, PA
19152-2081

Practice Phone: 215-331-7001
Practice Fax: 215-331-7004

1831366186 — DR. NICHOLAS STEPHEN PATAPIS PSY.D.
Practice Location Address:

8400 ROOSEVELT BLVD , SUITE 206
PHILADELPHIA, PA
19152-2081

Practice Phone: 215-333-7562
Practice Fax:

Directions to “PHILADELPHIA SURGICAL, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.