NPIMap

Individual provider Active NPI

Victor Elias Ghantous, M.D

  • Nephrology Physician
  • Willow Grove, PA
National Provider Identifier
1356363253
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD068220L Issued in PA
Practice address
735 Fitzwatertown Rd
Willow Grove, PA 19090-1332
Phone
(215) 657-2012
Fax
(215) 657-2018
NPI assigned
Jul 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD068220L PA Primary

Addresses

Primary practice location

735 Fitzwatertown Rd
Willow Grove, PA 19090-1332

Mailing address

735 Fitzwatertown Rd
Willow Grove, PA 19090-1332
Phone (215) 657-2012

Other identifiers 8

IdentifierTypeStateIssuer
02334MD0682207LOtherPAHEALTH PARTNERS
8672780OtherPACIGNA
0332424000OtherPAKEYSTONE
0175174602OtherAMERICHOICE
390006246OtherPARR MEDICARE
5333735OtherPAAETNA
1099042OtherPAKEYSTONE MERCY
529058OtherPAHIGHMARK BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20110318000733 PA Practitioner - NephrologyPractitioner - Internal Medicine 2567645161 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hypertension Nephrology Associates PCGroup PAC ID 6103809967, 17 clinicians

Practice addresses (Care Compare)

735 Fitzwatertown Rd
Suite 1
Willow Grove, PA 19090-1338
Phone (215) 657-2012

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD068220LPAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amh Medical Staff Service Fund CurrentSince Oct 11, 2023 Accepting new patients
Hypertension Nephrology Associates, PC Nephrology CurrentSince Apr 29, 1999 Accepting new patients

Locations

1200 York Rd
Abington, PA 19001
Phone (215) 481-2222

721 Arbor Way
Ste 103
Blue Bell, PA 19422
Phone (215) 257-6315

2510 Maryland Rd
Ste 200
Willow Grove, PA 19090

2500 Maryland Rd
Ste 400
Willow Grove, PA 19090
Phone (215) 481-3915

735 Fitzwatertown Rd
Ste 1
Willow Grove, PA 19090
Phone (215) 657-2012

3940B Commerce Ave
Willow Grove, PA 19090
Phone (215) 657-2012

735 Fitzwatertown Rd
Willow Grove, PA 19090
Phone (215) 657-2012

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1356363253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 FITZWATERTOWN RD",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901332",
            "telephone_number": "215-657-2012",
            "fax_number": "215-657-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 FITZWATERTOWN RD",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901332",
            "telephone_number": "215-657-2012",
            "fax_number": "215-657-2018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHANTOUS",
        "first_name": "VICTOR",
        "middle_name": "ELIAS",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD068220L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "02334MD0682207L",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8672780",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "0332424000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "0175174602",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "390006246",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5333735",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "1099042",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "529058",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Grove, PA

Sources for this page

Verify at the official NPI Registry.