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

Dr. Ramon Omar Vicencio, MD

Individual provider Sports Medicine (Family Medicine) Physician · NPI 1083292130

Dr. Ramon Omar Vicencio, MD is a Family Practice in Philadelphia, Pennsylvania. Qualified in 2019, 7 years ago. Practices with Temple Faculty Practice Plan Inc, a 1,314-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
7
Licensed in
PA
In the registry since
2021
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

10 Shurs Ln
Philadelphia, PA 19127-2123
Phone: (215) 482-1234
Fax: (215) 482-0465
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X · Licence MD484891 (PA)

Record details

NPI number1083292130
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 31, 2021
Last updated in NPPESJanuary 29, 2026
Certification dateJanuary 29, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Temple Faculty Practice Plan Inc — 1314 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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