Individual provider Active NPI

Vincent M Digiovanni, D.O.

  • Vascular Surgery Physician
  • Media, PA
National Provider Identifier
1154361277
Registry record updated Oct 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
OS011824 Issued in PA
Practice address
1098 W Baltimore Pike
Suite 3308 Riddle Health Center 3
Media, PA 19063-5139
Phone
(610) 565-8564
Fax
(610) 565-3046
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X OS011824 PA Primary

Addresses

Primary practice location

1098 W Baltimore Pike
Suite 3308 Riddle Health Center 3
Media, PA 19063-5139

Mailing address

1098 W Baltimore Pike
Suite 3308 Riddle Health Center 3
Media, PA 19063-5139
Phone (610) 565-8564

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
I20050426001089 PA Practitioner - Vascular SurgeryPractitioner - General Surgery 3779522149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Philadelphia College of Osteopathic Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

1098 W Baltimore Pike
Media, PA 19063-5139
Phone (610) 565-8564

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal32
Leg revascularization (restoring blood flow)92
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS011824PAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare CurrentSince Jul 1, 2012 Accepting new patients
Main Line Hospitals, Inc. Past Accepting new patients
Sancor Medical Enterprises, LLC Past Accepting new patients

Locations

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

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

1098 W Baltimore Pike
Ste 3308
Media, PA 19063
Phone (610) 565-8564

100 E Lancaster Ave
Ste 222
Wynnewood, PA 19096
Phone (610) 565-8564

Organizations & group practices 3

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 4

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445385600000",
    "number": "1154361277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1098 W BALTIMORE PIKE",
            "address_2": "SUITE 3308 RIDDLE HEALTH CENTER 3",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635139",
            "telephone_number": "610-565-8564",
            "fax_number": "610-565-3046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1098 W BALTIMORE PIKE",
            "address_2": "SUITE 3308 RIDDLE HEALTH CENTER 3",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635139",
            "telephone_number": "610-565-8564",
            "fax_number": "610-565-3046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIGIOVANNI",
        "first_name": "VINCENT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2015-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "OS011824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.