Evan Ryan Gooberman, DO, MPH

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS021758 Issued in PA

Practice address

401 W Allegheny Ave
Philadelphia, PA 19133-3644

Phone

(215) 291-2500

NPI assigned

Mar 19, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Family Practice

Education

Philadelphia College of Osteopathic Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Delaware Valley Community Health, Inc.Group PAC ID 8426967175, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Immediate Homecare and Hospice Home health agency, Philadelphia, PA, CCN 397650

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: evan.gooberman.p1@direct.dvch.nextgenshare.com

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.

• Delaware Valley Community Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1386864502
  Medicare reassignment Care Compare group NPD
• Delaware Valley Community Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1235956921
  NPD
• Delaware Valley Community Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1114940582
  NPD (past)
• Delaware Valley Community Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1285699686
  NPD (past)
• Delaware Valley Community Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Sharon Hill, PA
  • NPI 1295279644
  NPD (past)

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1114486909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W ALLEGHENY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191333644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W ALLEGHENY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191333644",
            "telephone_number": "215-291-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Old York Rd",
            "address_purpose": "LOCATION",
            "city": "Abington",
            "state": "PA",
            "postal_code": "190013788",
            "country_code": "US",
            "telephone_number": "215-481-2606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOOBERMAN",
        "first_name": "EVAN",
        "middle_name": "RYAN",
        "credential": "DO, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS021758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Gonzalez, MD, MA
• Sabrina Marie Gonzalez, MD
• Virginia Gonzalez
• Yunisse Gonzalez, MD
• Michael Daniel Gonzon, D.C.
• Michael Reid Gooch, M.D.
• Good Family Support Services
• Good Fortune Physical Therapy
• Good Friends Home Care
• Good Guidance Home Care Agency LLC

• Family Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; 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.