Individual provider Active NPI

Guy M Nardella Jr., M.D.

  • Plastic Surgery Physician
  • Media, PA
National Provider Identifier
1114933892
Registry record updated Feb 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MD016920E Issued in PA
Practice address
1118 W Baltimore Pike Ste 100
Media, PA 19063
Phone
(484) 227-8350
Fax
(484) 227-1645
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X MD016920E PA
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X C10006654 DE
Plastic Surgery Physician 208200000X MD016920E PA Primary

Addresses

Primary practice location

1118 W Baltimore Pike Ste 100
Media, PA 19063

Mailing address

1118 W Baltimore Pike Ste 100
Media, PA 19063-6105
Phone (484) 227-8350

Other practice location 1

1088 W Baltimore Pike Ste 2405
Media, PA 19063-5136
Phone (610) 566-6744

Other practice location 2

1118 W Baltimore Pike Ste 100
Media, PA 19063
Phone (484) 227-8350

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
I20111104000088 PA Practitioner - Plastic and Reconstructive SurgeryPractitioner - Hand SurgeryPractitioner - Undersea and Hyperbaric Medicine 6002098043 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Hand Surgery, Undersea and Hyperbaric Medicine
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

1068 W Baltimore Pike
Media, PA 19063-5104
Phone (610) 566-9400

830 Old Lancaster Rd
Bryn Mawr, PA 19010-3118

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare CurrentSince Aug 1, 2018 Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

1088 W Baltimore Pike
Ste 2405
Media, PA 19063
Phone (610) 566-6744

1068 W Baltimore Pike
Media, PA 19063
Phone (610) 566-9400

1118 W Baltimore Pike
Ste 100
Media, PA 19063
Phone (484) 227-8350

1088 W Baltimore Pike
Ste 2403
Media, PA 19063
Phone (484) 444-2151

Organizations & group practices 1

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.

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1114933892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 W BALTIMORE PIKE STE 100",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190636105",
            "telephone_number": "484-227-8350",
            "fax_number": "484-227-1645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 W BALTIMORE PIKE STE 100",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "19063",
            "telephone_number": "484-227-8350",
            "fax_number": "484-227-1645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1088 W Baltimore Pike Ste 2405",
            "address_purpose": "LOCATION",
            "city": "Media",
            "state": "PA",
            "postal_code": "190635136",
            "country_code": "US",
            "telephone_number": "610-566-6744",
            "fax_number": "610-566-6722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1118 W Baltimore Pike Ste 100",
            "address_purpose": "LOCATION",
            "city": "Media",
            "state": "PA",
            "postal_code": "19063",
            "country_code": "US",
            "telephone_number": "484-227-8350",
            "fax_number": "484-227-1645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NARDELLA",
        "first_name": "GUY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "PA",
            "license": "MD016920E",
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "DE",
            "license": "C10006654",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "PA",
            "license": "MD016920E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.