Individual provider Active NPI

John R Gimpel, D.O.

  • Family Medicine Physician
  • Bryn Mawr, PA
National Provider Identifier
1376533596
Registry record updated Jan 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS006854L Issued in PA
Practice address
135 S Bryn Mawr Ave Ste 200
Bryn Mawr, PA 19010-3129
Phone
(610) 325-1390
Fax
(610) 325-1373
NPI assigned
Oct 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS006854L PA Primary

Addresses

Primary practice location

135 S Bryn Mawr Ave Ste 200
Bryn Mawr, PA 19010-3129

Mailing address

135 S Bryn Mawr Ave Ste 200
Bryn Mawr, PA 19010-3129
Phone (610) 325-1390

Other practice location 1

1991 Sproul Rd
Suite 300
Broomall, PA 19008-3512
Phone (610) 325-1390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050315000305 PA Practitioner - Family Practice 9931154739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

135 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3129

830 Old Lancaster Rd
Bryn Mawr, PA 19010-3118

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Family Medicine CurrentSince Sep 29, 2010 Accepting new patients
Athens Nutrition, LLC Past Accepting new patients

Locations

1991 Sproul Rd
Ste 300
Broomall, PA 19008
Phone (610) 325-1373

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

830 Old Lancaster Rd
Ste 209
Bryn Mawr, PA 19010
Phone (610) 525-1061

135 S Bryn Mawr Ave
Ste 200
Bryn Mawr, PA 19010
Phone (610) 325-1390

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.

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1376533596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 S BRYN MAWR AVE STE 200",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103129",
            "telephone_number": "610-325-1390",
            "fax_number": "610-325-1373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S BRYN MAWR AVE STE 200",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103129",
            "telephone_number": "610-325-1390",
            "fax_number": "610-325-1373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1991 Sproul Rd",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Broomall",
            "state": "PA",
            "postal_code": "190083512",
            "country_code": "US",
            "telephone_number": "610-325-1390",
            "fax_number": "610-325-1373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIMPEL",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS006854L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.