Individual provider Active NPI

David Bronstein, DO

  • Internal Medicine Physician
  • Harrisburg, PA
National Provider Identifier
1194758094
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS000511L Issued in PA
Practice address
4830 Londonderry Rd
Harrisburg, PA 17109-5207
Phone
(717) 657-2595
Fax
(717) 441-0116
NPI assigned
Jul 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS000511L PA Primary

Addresses

Primary practice location

4830 Londonderry Rd
Harrisburg, PA 17109-5207

Mailing address

4830 Londonderry Rd
Harrisburg, PA 17109-5207
Phone (717) 657-2595

Other identifiers 3

IdentifierTypeStateIssuer
50001720OtherPACAPITAL BLUE CROSS
0716072MedicaidPA
041175OtherPAHIGHMARK BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS000511LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
David Bronstein DO Richard H Jeffries DO Professional Assoc Internal Medicine Current Accepting new patients

Locations

4830 Londonderry Rd
Harrisburg, PA 17109
Phone (717) 657-2595

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194758094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4830 LONDONDERRY RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171095207",
            "telephone_number": "717-657-2595",
            "fax_number": "717-441-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4830 LONDONDERRY RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171095207",
            "telephone_number": "717-657-2595",
            "fax_number": "717-441-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRONSTEIN",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS000511L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50001720",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0716072",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "041175",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.