NPIMap

Individual provider Active NPI

Sanjeev Bongu, M.D.

  • Internal Medicine Physician
  • Elkins Park, PA
National Provider Identifier
1306877048
Registry record updated Jun 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD054621L Issued in PA
Practice address
60 Township Line Rd
Elkins Park, PA 19027-2220
Phone
(215) 456-6500
NPI assigned
Jul 5, 2006
Last updated
Jun 10, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2011

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 MD054621L PA Primary

Addresses

Primary practice location

60 Township Line Rd
Elkins Park, PA 19027-2220

Mailing address

101 E Olney Ave
Suite 400
Philadelphia, PA 19120-2421
Phone (215) 456-6500

Other identifiers 1

IdentifierTypeStateIssuer
951882C2DOtherNJMEDICARE BILLING NO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, GA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041012000856 NJ Practitioner - Internal Medicine 1456311778 Reassigns benefits to 1 organization
I20130913000347 GA Practitioner - Internal Medicine 1456311778 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Houston Hospitalist Group LLCGroup PAC ID 2769813906, 48 clinicians

Practice addresses (Care Compare)

1601 Watson Blvd
Warner Robins, GA 31093-3431
Phone (478) 922-4281

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of New Jersey Omb Centralized Payroll CurrentSince Sep 10, 2021 Accepting new patients
State of New Jersey Omb Centralized Payroll CurrentSince Sep 10, 2021 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince May 16, 2020 Accepting new patients
Houston Hospitalist Group LLC CurrentSince May 20, 2020 Accepting new patients
Houston Hospitalist Group LLC Current Accepting new patients
Northwest New Jersey Urgent Care Alliance PC Past Accepting new patients
Grove Inpatient Services Internal Medicine Past Accepting new patients
Executive Health Resources Clinical Staffing Solutions PC Internal Medicine Past Accepting new patients
Lerna Inpatient Services Internal Medicine Past Accepting new patients
Clinical Staffing Solutions P.C. Internal Medicine Past Accepting new patients
Hera Inpatient Services Internal Medicine Past Accepting new patients

Locations

3651 Wheeler Rd
Augusta, GA 30909
Phone (706) 651-3232

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: sanjeev.bongu@direct.einstein.edu

Organizations & group practices 11

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 2

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307664000000",
    "number": "1306877048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E OLNEY AVE",
            "address_2": "SUITE 400",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202421",
            "telephone_number": "215-456-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 TOWNSHIP LINE RD",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190272220",
            "telephone_number": "215-456-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONGU",
        "first_name": "SANJEEV",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2011-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD054621L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE BILLING NO",
            "identifier": "951882C2D",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkins Park, PA

Sources for this page

Verify at the official NPI Registry.