Individual provider Active NPI

Vincenzo Berghella, MD

  • Maternal & Fetal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1013919570
Registry record updated Jul 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
MD 052559L Issued in PA
Practice address
833 Chestnut St
1St Floor
Philadelphia, PA 19107-4414
Phone
(215) 955-5000
Fax
(215) 923-1089
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X MD 052559L PA Primary
Obstetrics & Gynecology Physician 207V00000X MD052559L PA

Addresses

Primary practice location

833 Chestnut St
1St Floor
Philadelphia, PA 19107-4414

Mailing address

833 Chestnut St
1St Floor
Philadelphia, PA 19107-4414

Other identifiers 2

IdentifierTypeStateIssuer
6866506MedicaidNJ
0014900220010MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041221000453 PA Practitioner - Obstetrics/Gynecology 1658263140 Reassigns benefits to 1 organization
I20171211002398 NJ Practitioner - Obstetrics/Gynecology 1658263140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Jefferson Medical College of Thomas Jefferson University, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

33 S 9TH St FL
1 Jefferson Center for Womens Med Spe
Philadelphia, PA 19107-4408
Phone (215) 955-5000

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone (856) 513-4124

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD 052559LPAMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Medical Group Practice PC CurrentSince Oct 17, 2017 Accepting new patients
Kennedy Medical Group Practice, P.C. CurrentSince Oct 17, 2017 Accepting new patients
Kennedy Medical Group Practice, P.C. Obstetrics & Gynecology Current Accepting new patients
Jefferson University Physicians Obstetrics & Gynecology CurrentSince Oct 31, 1995 Accepting new patients
Kennedy Medical Group Practice P.C. Past Accepting new patients
Jefferson University Physicians Past Accepting new patients
Thomas Jefferson University Hospitals Inc Past Accepting new patients

Locations

208 White Horse Pike
Ste 14
Barrington, NJ 08007
Phone (609) 547-4484

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

205 E Laurel Rd
Stratford, NJ 08084
Phone (856) 344-7360

1648 Huntingdon Pike
Meadowbrook, PA 19046
Phone (215) 938-3413

833 Chestnut St
Fl 1
Philadelphia, PA 19107
Phone (215) 955-1085

834 Chestnut St
Ste 300
Philadelphia, PA 19107
Phone (215) 955-2117

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1013919570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST",
            "address_2": "1ST FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST",
            "address_2": "1ST FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074414",
            "telephone_number": "215-955-5000",
            "fax_number": "215-923-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGHELLA",
        "first_name": "VINCENZO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "PA",
            "license": "MD 052559L",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD052559L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6866506",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014900220010",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.