Active NPI
Laura Share Immordino, M.D.
- Cardiovascular Disease Physician
- Bryn Mawr, PA
National Provider Identifier
1043428063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- MD-440263
- Practice address
- 825 Old Lancaster Rd
Suite 320
Bryn Mawr, PA 19010-3231 - Phone
- (610) 525-1202
- Fax
- (610) 527-0308
- NPI assigned
- May 21, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | MD-440263 | PA | Primary |
Addresses
Primary practice location
825 Old Lancaster Rd
Suite 320
Bryn Mawr, PA 19010-3231
Mailing address
825 Old Lancaster Rd
Suite 400
Bryn Mawr, PA 19010-3231
Phone (610) 525-1202
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1027138400005 | Medicaid | PA |
Other names 1
- Laura Elizabeth Share
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120611000402 | PA | Practitioner - Cardiovascular Disease (Cardiology) | 1254595812 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Jenner Medical College, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bryn Mawr Medical Specialists Association
Practice addresses (Care Compare)
825 Old Lancaster Rd
Suite 320
Bryn Mawr, PA 19010-3235
Phone (610) 527-3800
Hospital & facility affiliations
- Bryn Mawr Hospital
- Main Line Hospital Lankenau
- Paoli Hospital
- Riddle Memorial Hospital
- Hospital of Univ of Pennsylvania
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD-440263 | PA | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bryn Mawr Medical Specialists Association | Current | Accepting new patients | |
| Main Line Healthcare | Past | Accepting new patients |
Locations
825 Old Lancaster Rd
Ste 400
Bryn Mawr, PA 19010
Phone (610) 525-1202
825 Old Lancaster Rd
Ste 320
Bryn Mawr, PA 19010
Phone (610) 524-3800
130 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (484) 337-3000
255 W Lancaster Ave
Paoli, PA 19301
Phone (484) 337-4286
100 E Lancaster Ave
Ste 558
Wynnewood, PA 19096
100 E Lancaster Ave
Ste 356
Wynnewood, PA 19096
Phone (484) 476-2684
Interoperability endpoints
- laura.share-immordino@bmmsa.directbygreenway.com
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.
-
- Multi-Specialty Clinic/Center
- Bryn Mawr, PA
- NPI 1841226099
PA
-
- Ambulatory Surgical Clinic/Center
- Bryn Mawr, PA
- NPI 1205963568
-
- Family Medicine Physician
- Newtown Square, PA
- NPI 1922077643
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Philadelphia, PA
- NPI 1851370910
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491350400000",
"number": "1043428063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 OLD LANCASTER RD",
"address_2": "SUITE 400",
"city": "BRYN MAWR",
"state": "PA",
"postal_code": "190103231",
"telephone_number": "610-525-1202",
"fax_number": "610-527-0334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 OLD LANCASTER RD",
"address_2": "SUITE 320",
"city": "BRYN MAWR",
"state": "PA",
"postal_code": "190103231",
"telephone_number": "610-525-1202",
"fax_number": "610-527-0308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHARE IMMORDINO",
"first_name": "LAURA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-21",
"last_updated": "2017-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "PA",
"license": "MD-440263",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1027138400005",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LAURA",
"last_name": "SHARE",
"middle_name": "ELIZABETH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bryn Mawr, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.