Individual provider Active NPI

Joseph V Pongonis, D.O.

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1023026713
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS004384-L Issued in PA
Practice address
8019 Frankford Ave
Philadelphia, PA 19136-2736
Phone
(215) 332-1300
Fax
(215) 332-5219
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS004384-L PA Primary

Addresses

Primary practice location

8019 Frankford Ave
Philadelphia, PA 19136-2736

Mailing address

8019 Frankford Ave
Philadelphia, PA 19136-2736
Phone (215) 332-1300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20090803000434 PA Practitioner - Family PracticePractitioner - Other (Physician) 7810947736

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS004384-LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Physicians L.L.C. CurrentSince Oct 14, 2013 Accepting new patients
Pain Management Physicians, LLC Past Accepting new patients
Pain Management Physicians, LLC PastSince Jan 1, 2023 Accepting new patients

Locations

8021 Frankford Ave
Philadelphia, PA 19136
Phone (215) 332-4440

Organizations & group practices 3

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023026713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8019 FRANKFORD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191362736",
            "telephone_number": "215-332-1300",
            "fax_number": "215-332-5219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8019 FRANKFORD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191362736",
            "telephone_number": "215-332-1300",
            "fax_number": "215-332-5219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONGONIS",
        "first_name": "JOSEPH",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS004384-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.