Old City residents (19106) get virtual-first primary care from Fishtown Medicine. Care happens by text, video, and home visit so you can stay on the cobblestones.
Clinical care for Old City residents
Whether you're in Old City or nearby, these are the areas we help with most:
- Longevity & Medicine 3.0 - healthspan optimization and advanced diagnostics
- Metabolic health & weight - insulin resistance, blood sugar, and GLP-1 medications
- Hormone optimization - testosterone, thyroid, perimenopause and menopause
- Cardiovascular risk - apoB, Lp(a), and early prevention
- Performance & recovery - VO2 max, muscle, and sleep
- Our supplement guide - professional-grade picks from Dr. Ash
Tell Dr. Ash what's going on to talk through your health goals as an Old City patient.
Related at Fishtown Medicine
- Society Hill - the historic district just south of Old City
- Queen Village - south of South Street, between river and Italian Market
- Bella Vista - the Italian Market neighborhood
- Southwark - the riverfront south-of-Pine neighborhood
Fishtown Medicine | Neighborhoods
Old City is a contradiction in the best way. Cobblestone streets and Independence Hall on one block, the heart of Philadelphia's tech scene (Philly Tech Week, N3rd Street, the design agencies along 3rd) on the next. Living here means you value aesthetics and innovation.
Fishtown Medicine aligns with that. We bring 21st-century efficiency to the 19106. Ashvin Vijayakumar MD ("Dr. Ash") is a board-certified internal medicine physician you can text directly. Most visits happen by video. When you need an in-person exam, we come to your loft.
What anchors your week in Old City?
Old City runs on overlapping rhythms that most of you can walk between in five minutes. Our 19106 members move through the historic, the creative, and the tech corridors without leaving the neighborhood.
The N3rd Street tech corridor. Design agencies, startups, freelancers working from a loft conversion on 3rd or Arch. Old City Coffee for the morning. The Bourse food hall for the working lunch. Sassafras or Wedge + Fig for the quick dinner before the late session. Most of our Old City tech members text us between meetings; the 12-minute window is where care fits.
First Friday and the gallery weekend. The 3rd Street art walks, dinner at Royal Boucherie or Spasso, drinks at Eulogy after. A meaningful share of our Old City members work in or around design, gallery, or publishing, and they recognize a relationship-based practice when they see one. We work the same way, building care over a long conversation.
The Race and Cherry Street Pier mornings. Race Street Pier for the river views and the dog walk. Cherry Street Pier for the creative coworking on the way back. The 6 am Delaware Ave runners with the Ben Franklin Bridge as the backdrop. Old City has one of the best waterfront pockets in Center City, and we see a lot of "I have time to take this seriously now" conversations happen out there.
The Old City pattern is creative, design-conscious, and built for people who notice details. Care should match that.
Where do members go for labs and imaging?
Old City is well covered:
- Quest Diagnostics in Center City and on Aramingo.
- LabCorp locations on Walnut and at 30th Street Station.
- Mobile phlebotomy to your loft.
For imaging, we send orders to Jefferson, Penn, or independent imaging centers.
I work in tech, design, or hospitality in Old City. Does this fit?
Yes. The N3rd Street tech and design crowd appreciate a digitally native medical practice. The hospitality and restaurant industry crowd (Zahav, Amada, Royal Boucherie) appreciate flexible access for non 9-to-5 schedules. We handle both.
Actionable Steps for Old City Residents
- Book a free 20-minute warm invitation call. No pressure.
- Send your records. We import labs, imaging, and specialist notes.
- Save Dr. Ash's number. Members text Dr. Ash directly instead of working through a portal or a phone tree.
Deeper Questions for Old City Residents
I have a chronic condition (anxiety, hypertension, GERD). How does this work in 19106?
We manage most chronic conditions inside the membership: hypertension, anxiety, depression, ADHD evaluation, GERD, prediabetes, lipids, hypothyroidism, IBS, and chronic insomnia. The change compared to traditional primary care is more time, more access, and continuity.
Are there health concerns specific to historic Old City buildings?
Yes:
- Lead paint and lead pipes in pre-1978 buildings. Most of Old City qualifies. We can order a blood lead level if you are renovating or planning to conceive.
- Asbestos in older basements and pipe wrap; renovation timing matters.
- Mold in old foundations and slow-leaking roofs.
- Indoor air quality in tightly sealed warehouse conversions and gas-stove kitchens.
What about air quality near I-95 and the waterfront?
I-95 runs along the eastern edge of Old City, so the waterfront blocks catch particulate exposure from the highway traffic. We screen for asthma, allergies, and unexplained chronic cough, and we talk through HEPA filtration and route choice for runs and bike commutes.
Is Old City walkable enough for daily movement?
Walk Score is in the 90s here. Between the Delaware River Trail, Penn's Landing, the cobblestones, and the connectors to Society Hill and NoLibs, you have plenty of options for daily movement, and we build plans around them.
I work in restaurants in Old City. Sleep is wrecked.
This is a common Old City pattern. We run a sleep workup that goes past "go to bed earlier," looking at chronotype, light exposure, alcohol timing, late-night eating, and a sleep apnea screen, and we use wearable data when you have it.
I am a freelancer or consultant without traditional benefits. Does this work?
Yes. This is who membership is built for. It replaces the "I just need a good doctor" piece, while you keep catastrophic insurance for ER, hospital, and specialist costs. For most freelancers, the math works in your favor.
I want longevity care that goes beyond sick care. What do you offer?
Most Old City members come to us for this. The longevity layer includes:
- ApoB and Lp(a) for cardiovascular risk.
- Insulin sensitivity to catch metabolic dysfunction early.
- Hormones (testosterone, thyroid, cortisol).
- DEXA for body composition and bone density.
- VO2 max guidance.
How does Fishtown Medicine compare to Jefferson primary care?
Jefferson is great for hospital and specialty care. Their primary care runs on insurance economics: 12-15 minute visits, large panels, weeks-long scheduling. We are direct primary care: long first visits, same-day text access, no rotating residents. We refer into Jefferson for specialty care.
I want an executive physical without leaving Old City. Can I get one?
Yes. Our annual deep-dive includes advanced lipidology, hormones, insulin, body composition, VO2 max guidance, and a written 12-month plan. Most of it happens between video, your loft, and one lab visit.
Discretion and privacy?
Virtual visits are private. No bumping into colleagues or clients in a Center City lobby. Standard HIPAA, secure tools.
I am opening or running a restaurant in Old City. Can you handle the stress and erratic hours?
Yes. Many of our hospitality members are owners and chefs. We are pragmatic about industry life and we work with what you have, not what you wish you had.
Meet Your Physician
Ashvin Vijayakumar MD (Dr. Ash) is a board-certified internal medicine physician based in Philadelphia. He built Fishtown Medicine to give Old City's tech founders, hospitality professionals, and creatives a doctor who fits their schedules.
Frequently Asked Questions
Common Questions
Ready when you are
Dr. Ash reads every intake himself, and answers questions personally - usually within a few hours.
