Kourosh C Ghalili, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

MD429774 Issued in PA

Practice address

3070 Bristol Pike Ste 2-106
Bensalem, PA 19020-5357

Phone

(215) 447-8612

Fax

(267) 522-8209

NPI assigned

Aug 31, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Thoracic SurgeryAlso: Vascular Surgery

Education

University of Massachusetts Medical School, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Health- Northeast Hospital, Philadelphia, PA, CCN 390115

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Comprehensive Geriatric Medicine

  • Geriatric Medicine (Family Medicine) Physician
  • Huntingdon Valley, PA
  • NPI 1124593231
  NPD (past)
• Bergen Optometry Group, PA

  • Optometrist
  • Hackensack, NJ
  • NPI 1679634208
  NPD (past)
• Charleston Area Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Belpre, OH
  • NPI 1588422547
  NPD (past)
• Herbert J. Thomas Memorial Hospital Association

  • General Acute Care Hospital
  • South Charleston, WV
  • NPI 1316925506
  NPD (past)
• Integrated Health Care Providers

  • Multi-Specialty Clinic/Center
  • Charleston, WV
  • NPI 1922123587
  NPD (past)

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

• Jefferson Health - Northeast

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1801963343
  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1053305490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 BRISTOL PIKE STE 2-106",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190205357",
            "telephone_number": "215-447-8612",
            "fax_number": "267-522-8209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 BRISTOL PIKE STE 2-106",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190205357",
            "telephone_number": "215-447-8612",
            "fax_number": "267-522-8209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHALILI",
        "first_name": "KOUROSH",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PA",
            "license": "MD429774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018398010001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018398010002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gentox, LLC
• Veronica Saywear George, BA
• Lori Ilyse Gerber, DO
• Marc Gary Getman, O.D.
• Zuhal Ghafary
• Gia Medix LLC
• Gia Medix LLC
• Gia Medix LLC
• Nicholas Giantomaso
• Tyleshia Necole Gilbert, MS

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Bensalem, PA
• Providers in Bensalem, PA by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; 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.

Verify at the official NPI Registry.