Individual provider Active NPI

Mira Manhar Gohel, M.D.

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1306859806
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD048340L Issued in PA
Practice address
555 S 43Rd St
Health Care Center #3
Philadelphia, PA 19104-4408
Phone
(215) 685-7504
Fax
(215) 685-7551
NPI assigned
Aug 14, 2006
Sex
Female
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
Family Medicine Physician 207Q00000X MD048340L PA Primary

Addresses

Primary practice location

555 S 43Rd St
Health Care Center #3
Philadelphia, PA 19104-4408

Mailing address

500 S Broad St
Suite 360
Philadelphia, PA 19146-1613
Phone (215) 685-6769

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
I20110914000271 PA Practitioner - Family Practice 8426229964 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
City of Philadelphia CurrentSince Feb 7, 2017 Accepting new patients
City of Philadelphia Current Accepting new patients

Locations

4400 Haverford Ave
#4
Philadelphia, PA 19104
Phone (215) 685-7600

555 S 43rd St
#3
Philadelphia, PA 19104
Phone (215) 685-7504

500 S Broad St
Ste 360
Philadelphia, PA 19146

4400 Haverford Ave
Philadelphia, PA 19104
Phone (215) 685-7504

1101 Market St
Fl 10
Philadelphia, PA 19107

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306859806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S BROAD ST",
            "address_2": "SUITE 360",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461613",
            "telephone_number": "215-685-6769",
            "fax_number": "215-685-6732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S 43RD ST",
            "address_2": "HEALTH CARE CENTER #3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044408",
            "telephone_number": "215-685-7504",
            "fax_number": "215-685-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOHEL",
        "first_name": "MIRA",
        "middle_name": "MANHAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD048340L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.