Individual provider Active NPI

Frederick Gmora, D.O.

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1366874372
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS020406 Issued in PA
Practice address
10800 Knights Rd
Philadelphia, PA 19114-4200
Phone
(856) 566-6875
NPI assigned
Jul 31, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 25MB12090100 NJ
Emergency Medicine Physician 207P00000X OS020406 PA Primary

Addresses

Primary practice location

10800 Knights Rd
Philadelphia, PA 19114-4200

Mailing address

10800 Knights Rd
Philadelphia, PA 19114-4200

Other practice location 1

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone (856) 513-4124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200330002297 PA Practitioner - Emergency Medicine 4183910490 Reassigns benefits to 2 organizations
I20240227000514 NJ Practitioner - Critical Care (Intensivists) 4183910490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Lake Erie College of Osteopathic Medicine, Erie, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kennedy Medical Group Practice, P.C.Group PAC ID 2860616877, 417 clinicians

Practice addresses (Care Compare)

205 E Laurel Rd
Jefferson Health OBGYN Stratford
Stratford, NJ 08084-1301
Phone (844) 542-2273

Hospital & facility affiliations

  • Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086
  • Cooper University Hospital Hospital, Camden, NJ, CCN 310014

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aria Health Physician Services CurrentSince Apr 1, 2020 Accepting new patients
Aria Health Physician Services Current Accepting new patients
Kennedy Medical Group Practice, P.C. CurrentSince Feb 14, 2024 Accepting new patients
Jefferson Acute Care Physicians, PC CurrentSince Apr 1, 2020 Accepting new patients
Kennedy Medical Group Practice PC CurrentSince Feb 14, 2024 Accepting new patients
Aria Health Physician Services Surgical Critical Care CurrentSince Apr 1, 2020 Accepting new patients
Jefferson Acute Care Physicians, PC Current Accepting new patients
Jefferson Acute Care Physicians, PC CurrentSince Apr 1, 2020 Accepting new patients
Kennedy University Hospital Inc. Past Accepting new patients
Rowan University School of Osteopathic Medicine Past Accepting new patients

Locations

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

205 E Laurel Rd
Stratford, NJ 08084
Phone (856) 344-7360

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012
Phone (856) 513-4124

165 Princeton Ave
West Deptford, NJ 08096
Phone (856) 384-0210

2966 Street Rd
Bensalem, PA 19020
Phone (215) 638-0666

10800 Knights Rd
Philadelphia, PA 19114
Phone (215) 612-2610

4900 Frankford Ave
Philadelphia, PA 19124
Phone (215) 612-2610

3998 Red Lion Rd
Philadelphia, PA 19114
Phone (215) 612-4060

1101 Market St
Fl 19
Philadelphia, PA 19107
Phone (215) 481-6836

2451 Grant Ave
Philadelphia, PA 19114
Phone (215) 464-8050

Organizations & group practices 10

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 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": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1366874372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200",
            "telephone_number": "856-566-6875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 Hurffville Cross Keys Rd",
            "address_purpose": "LOCATION",
            "city": "Turnersville",
            "state": "NJ",
            "postal_code": "080122453",
            "country_code": "US",
            "telephone_number": "856-513-4124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GMORA",
        "first_name": "FREDERICK",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-31",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NJ",
            "license": "25MB12090100",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS020406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.