Individual provider Active NPI

Laura Share Immordino, M.D.

  • Cardiovascular Disease Physician
  • Bryn Mawr, PA
National Provider Identifier
1043428063
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD-440263 Issued in PA
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
Last updated
Apr 5, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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 names 1

  • Laura Elizabeth Share Former name

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
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

Practice addresses (Care Compare)

825 Old Lancaster Rd
Suite 320
Bryn Mawr, PA 19010-3235
Phone (610) 527-3800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-440263PAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bryn Mawr Medical Specialists Association CurrentSince Jan 1, 2013 Accepting new patients
Main Line Healthcare Past Accepting new patients

Locations

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (484) 337-3000

825 Old Lancaster Rd
Ste 320
Bryn Mawr, PA 19010
Phone (610) 524-3800

825 Old Lancaster Rd
Ste 400
Bryn Mawr, PA 19010
Phone (610) 525-1202

255 W Lancaster Ave
Paoli, PA 19301
Phone (484) 337-4286

100 E Lancaster Ave
Ste 356
Wynnewood, PA 19096
Phone (484) 476-2684

100 E Lancaster Ave
Ste 558
Wynnewood, PA 19096

Interoperability endpoints

  • Direct secure messaging: laura.share-immordino@bmmsa.directbygreenway.com

Organizations & group practices 2

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

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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": [],
    "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

Verify at the official NPI Registry.