Active NPI
Stephen Michael Gollomp, MD
- Neurology Physician
- Wynnewood, PA
National Provider Identifier
1194723585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- MD024887E
- Practice address
- 100 E Lancaster Ave
Suite 161
Wynnewood, PA 19096-3450 - Phone
- (610) 642-5371
- Fax
- (610) 642-5658
- NPI assigned
- Jul 11, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neurophysiology Physician | 2084N0600X | MD024887E | PA | |
| Neurology Physician | 2084N0400X | MD024887E | PA | Primary |
Addresses
Primary practice location
100 E Lancaster Ave
Suite 161
Wynnewood, PA 19096-3450
Mailing address
100 E Lancaster Ave
Suite 161
Wynnewood, PA 19096-3450
Phone (610) 642-5371
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0808737 | Medicaid | PA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Albany Medical College of Union University, 1976
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
100 E Lancaster Ave
Suite 161
Wynnewood, PA 19096-3427
Phone (610) 642-5371
Hospital & facility affiliations
- Main Line Hospital Lankenau
- Bryn Mawr Hospital
- Paoli Hospital
- Riddle Memorial Hospital
- Chester County Hospital
- Bryn Mawr Rehabilitation Hospital
- Good Shepherd Penn Partners
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD024887E | PA | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stephen M Gollomp MD PC | Neurology | Current | Accepting new patients |
Locations
100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583
100 E Lancaster Ave
Ste 161
Wynnewood, PA 19096
Phone (610) 642-5371
100 E Lancaster Ave
Ste 115
Wynnewood, PA 19096
Interoperability endpoints
- stephen.gollomp@sg.eclinicaldirectplus.com
- https://fhir4.healow.com/fhir/r4/DJEIBA/Endpoint/DJEIBA
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.
-
- Neurology Physician
- Wynnewood, PA
- NPI 1841350758
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- West Chester, PA
- NPI 1356333579
-
- General Acute Care Hospital
- Paoli, PA
- NPI 1215042114
-
- General Acute Care Hospital
- Wynnewood, PA
- NPI 1245335629
-
- Rehabilitation Hospital
- Malvern, PA
- NPI 1396850368
Inpatient rehabilitation facility
-
- General Acute Care Hospital
- Bryn Mawr, PA
- NPI 1508971441
-
- Long Term Care Hospital
- Philadelphia, PA
- NPI 1427232818
Long-term care hospital
-
- General Acute Care Hospital
- Media, PA
- NPI 1407856099
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519516800000",
"number": "1194723585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 E LANCASTER AVE",
"address_2": "SUITE 161",
"city": "WYNNEWOOD",
"state": "PA",
"postal_code": "190963450",
"telephone_number": "610-642-5371",
"fax_number": "610-642-5658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E LANCASTER AVE",
"address_2": "SUITE 161",
"city": "WYNNEWOOD",
"state": "PA",
"postal_code": "190963450",
"telephone_number": "610-642-5371",
"fax_number": "610-642-5658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLLOMP",
"first_name": "STEPHEN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-11",
"last_updated": "2018-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0600X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Clinical Neurophysiology",
"state": "PA",
"license": "MD024887E",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "PA",
"license": "MD024887E",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0808737",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wynnewood, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.