Active NPI
Nato Zangaladze
- Internal Medicine Physician
- Feasterville Trevose, PA
National Provider Identifier
1245935279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD495491
- Practice address
- 518 Bustleton Pike
Feasterville Trevose, PA 19053-6035 - Phone
- (215) 464-6040
- Fax
- (215) 464-6046
- NPI assigned
- Mar 31, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD495491 | PA | Primary |
Addresses
Primary practice location
518 Bustleton Pike
Feasterville Trevose, PA 19053-6035
Mailing address
3509 N Broad St
Philadelphia, PA 19140-4105
Phone (215) 707-3911
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230725003014 | VA | Order and Referring Only - Internal Medicine | 8921469867 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- nzangaladze105870@marywashingtonhealthcare.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790121600000",
"number": "1245935279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3509 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191404105",
"telephone_number": "215-707-3911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "518 BUSTLETON PIKE",
"city": "FEASTERVILLE TREVOSE",
"state": "PA",
"postal_code": "190536035",
"telephone_number": "215-464-6040",
"fax_number": "215-464-6046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZANGALADZE",
"first_name": "NATO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-31",
"last_updated": "2026-09-23",
"certification_date": "2026-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MD495491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Feasterville Trevose, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.