Individual provider Active NPI

Jody Borgman, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1235106378
Registry record updated Feb 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD045369L Issued in PA
Practice address
5501 Old York Rd
Klein, 363
Philadelphia, PA 19141-3018
Phone
(215) 456-6948
Fax
(215) 455-1933
NPI assigned
Mar 8, 2006
Last updated
Feb 20, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2015

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 MD045369L PA Primary

Addresses

Primary practice location

5501 Old York Rd
Klein, 363
Philadelphia, PA 19141-3018

Mailing address

5501 Old York Rd
Klein, 363
Philadelphia, PA 19141-3018
Phone (215) 456-6948

Other identifiers 1

IdentifierTypeStateIssuer
0012820200002MedicaidPA

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
I20110512000479 PA Practitioner - Internal Medicine 6002092848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

5401 Old York Rd
Suite 331
Philadelphia, PA 19141-3045
Phone (215) 572-5200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc Internal Medicine CurrentSince Jun 23, 1992 Accepting new patients
Einstein Practice Plan Inc CurrentSince Jun 23, 1992 Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients

Locations

1335 W Tabor Rd
Ste 309
Phila, PA 19141
Phone (215) 224-5623

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

5401 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-8220

5401 Old York Rd
Ste 331
Philadelphia, PA 19141
Phone (215) 456-6948

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

5501 York Rd
Ste 202
Philadelphia, PA 19141
Phone (215) 254-2630

Interoperability endpoints

  • Direct secure messaging: jody.borgman@direct.einstein.edu

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

Hospital & facility affiliations 1

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1235106378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "address_2": "KLEIN, 363",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-6948",
            "fax_number": "215-455-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "address_2": "KLEIN, 363",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-6948",
            "fax_number": "215-455-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORGMAN",
        "first_name": "JODY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD045369L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012820200002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.