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Individual provider Active NPI

Jacob Gildea, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Harrisburg, PA
National Provider Identifier
1366598971
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD-441990 Issued in PA
Practice address
100 S 2ND St
Ste 301
Harrisburg, PA 17101-2545
Phone
(717) 782-3340
Fax
(717) 782-5352
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Blood Banking & Transfusion Medicine Physician 207ZB0001X MD-441990 PA
Cytopathology Physician 207ZC0500X MD-441990 PA
Dermatopathology (Pathology) Physician 207ZD0900X MD-441990 PA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD-441990 PA Primary

Addresses

Primary practice location

100 S 2ND St
Ste 301
Harrisburg, PA 17101-2545

Mailing address

PO Box 536003
Pittsburgh, PA 15253-5902
Phone (800) 475-6236

Other identifiers 2

IdentifierTypeStateIssuer
1025892300001MedicaidPA
P00939323OtherPARAILROAD MEDICARE PTAN

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
I20110706000023 PA Practitioner - Pathology 9335327832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Pennsylvania State University College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Associates of Central Pennsylvania PCGroup PAC ID 6901709948, 11 clinicians

Practice addresses (Care Compare)

100 S 2ND St
Suite 301
Harrisburg, PA 17101-2545
Phone (800) 475-6236

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95 of 100Reported as group
Quality
90
Improvement activities
40

National Provider Directory

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

Organizations & group practices 1

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1366598971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 536003",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152535902",
            "telephone_number": "800-475-6236",
            "fax_number": "843-497-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S 2ND ST",
            "address_2": "STE 301",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171012545",
            "telephone_number": "717-782-3340",
            "fax_number": "717-782-5352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILDEA",
        "first_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "PA",
            "license": "MD-441990",
            "primary": false
        },
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "PA",
            "license": "MD-441990",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "PA",
            "license": "MD-441990",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "PA",
            "license": "MD-441990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1025892300001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P00939323",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.