Broad Street Professional Medical Services LLC
NPI 1720630650 · Vascular Surgery Physician · Philadelphia, PA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Broad Street Professional Medical Services LLC is a Vascular Surgery Physician organization in Philadelphia, PA (NPI 1720630650).
Provider details
- NPI number
- 1720630650
- Entity type
- Organization
- Primary specialty
- Vascular Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Ami Almeda, Credentialing Manager(224) 318-0118
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2019-07-11
- Last updated
- 2019-07-11
Frequently asked questions
- What is Broad Street Professional Medical Services LLC's NPI number?
- Broad Street Professional Medical Services LLC's National Provider Identifier (NPI) is 1720630650, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Broad Street Professional Medical Services LLC?
- Broad Street Professional Medical Services LLC is classified in the NPPES registry as Vascular Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Broad Street Professional Medical Services LLC located?
- Broad Street Professional Medical Services LLC's practice location on file with NPPES is 2033 S Broad St Ste a, Philadelphia, PA 19148-5505.
- What is Broad Street Professional Medical Services LLC's phone number?
- The practice phone number listed in the NPPES registry for Broad Street Professional Medical Services LLC is (215) 795-3855.
- Does Broad Street Professional Medical Services LLC accept Medicare?
- Broad Street Professional Medical Services LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Broad Street Professional Medical Services LLC?
- The authorized official listed on Broad Street Professional Medical Services LLC's NPPES record is Ami Almeda, Credentialing Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Broad Street Professional Medical Services LLC's NPI active?
- Yes — Broad Street Professional Medical Services LLC's NPI (1720630650) is active in the NPPES registry as of the last update on 2019-07-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.