NPIMap

Individual provider Active NPI

Gustavo Adolfo Fernandez Romero, M.D.

  • Pulmonary Disease Physician
  • Philadelphia, PA
National Provider Identifier
1104268986
Registry record updated Jul 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD467580 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-5864
Fax
(215) 707-6867
NPI assigned
Jul 23, 2013
Last updated
Jul 1, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X MD467580 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

5501 Old York Rd # 19141
Philadelphia, PA 19141-3018
Phone (215) 456-8520

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190802000453 PA Practitioner - Pulmonary Disease 9537495213 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-3326

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
49.71
Promoting interoperability
100
Improvement activities
40
Cost
74.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD467580PAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physicians Inc CurrentSince Aug 5, 2019 Accepting new patients
Temple Physician Inc. CurrentSince Aug 5, 2019 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Jul 1, 2019 Accepting new patients
KND Development 59 LLC Current Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
KND Development 59, LLC CurrentSince May 18, 2021 Accepting new patients
Temple Physicians Inc Current Accepting new patients
KND Development 59 LLC CurrentSince May 18, 2021 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Jul 1, 2019 Accepting new patients
Temple University Hospital, Inc Past Accepting new patients

Locations

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

2000 Old West Chester Pike
Havertown, PA 19083
Phone (610) 536-2100

445 Shady Ln
#2
Huntingdon Vy, PA 19006
Phone (215) 663-9095

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

6129 Palmetto St
Philadelphia, PA 19111
Phone (215) 722-8555

7600 Central Ave
Philadelphia, PA 19111
Phone (215) 707-5522

450 Cresson Blvd
Phoenixville, PA 19460
Phone (215) 707-5067

Organizations & group practices 10

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 8

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": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1104268986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD # 19141",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-8520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-5864",
            "fax_number": "215-707-6867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ ROMERO",
        "first_name": "GUSTAVO",
        "middle_name": "ADOLFO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-23",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PA",
            "license": "MD467580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.