NPIMap

Individual provider Active NPI

Adalberto De Jesus Gonzalez Pantaleon, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Moorestown, NJ
National Provider Identifier
1306916531
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
92880 Issued in GA
Practice address
740 Marne Hwy
Suite 206
Moorestown, NJ 08057
Phone
(856) 234-0645
Fax
(856) 234-0498
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD429605 PA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 25MA08785800 NJ
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 92880 GA Primary

Addresses

Primary practice location

740 Marne Hwy
Suite 206
Moorestown, NJ 08057

Mailing address

500 Grove Street
Suite 100
Haddon Heights, NJ 08035-1761
Phone (856) 796-9200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201231000274 OH Practitioner - Endocrinology 8123027828 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summa Physicians LLCGroup PAC ID 2961303532, 692 clinicians

Practice addresses (Care Compare)

525 E Market St
Akron, OH 44304-1619

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.65 of 100Reported as apm
Quality
86.21
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
92880GAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summa Physicians LLC CurrentSince Sep 30, 2024 Accepting new patients
Summa Physicians LLC Current Accepting new patients
Summa Physicians LLC CurrentSince Sep 30, 2024 Accepting new patients
Adena Medical Group LLC Internal Medicine CurrentSince Jan 18, 2021 Accepting new patients
Tenet Florida Physician Services, LLC Past Accepting new patients
Tenet Florida Physician Services LLC Internal Medicine PastSince Aug 23, 2020 Accepting new patients
Executive Health Resources Clinical Staffing Solutions PC Internal Medicine Past Accepting new patients

Locations

525 E Market St
Akron, OH 44304
Phone (330) 375-6350

1077 Gorge Blvd
Akron, OH 44310
Phone (234) 312-5691

4437 State Route 159
Ste 125
Chillicothe, OH 45601
Phone (740) 779-4570

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

Organizations & group practices 7

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 3

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1306916531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 GROVE STREET",
            "address_2": "SUITE 100",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "080351761",
            "telephone_number": "856-796-9200",
            "fax_number": "856-796-9397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 MARNE HWY",
            "address_2": "SUITE 206",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "08057",
            "telephone_number": "856-234-0645",
            "fax_number": "856-234-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ PANTALEON",
        "first_name": "ADALBERTO",
        "middle_name": "DE JESUS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD429605",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "25MA08785800",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "GA",
            "license": "92880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

Verify at the official NPI Registry.