Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Broad Street Medical LLC

Organization Vascular Surgery Physician · NPI 1124670922

Broad Street Medical LLC is a Vascular Surgery Physician in Philadelphia, Pennsylvania. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2033 S Broad St Ste B
Philadelphia, PA 19148-5505
Phone: (215) 809-1447
Fax: (224) 235-4652
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Vascular Surgery Physician (primary) Taxonomy 2086S0129X

Record details

NPI number1124670922
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ami Almeda — Credentialing Manager · (224) 318-0118
NPI enumeratedJuly 11, 2019
Last updated in NPPESJuly 11, 2019
Mailing addressPo Box 302, Northbrook, IL 60065-0302

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