NPIMap

Individual provider Active NPI

Graham Vigliotta, D.O.

  • Internal Medicine Physician
  • Audubon, PA
National Provider Identifier
1447414453
Registry record updated Feb 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS015096 Issued in PA
Practice address
950 Forge Ave
Suite 200
Audubon, PA 19403-2305
Phone
(484) 956-6000
Fax
(484) 956-6011
NPI assigned
Jul 18, 2008
Last updated
Feb 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS015096 PA Primary

Addresses

Primary practice location

950 Forge Ave
Suite 200
Audubon, PA 19403-2305

Mailing address

950 Forge Ave
Suite 200
Audubon, PA 19403-2305
Phone (484) 956-6000

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
I20110107000981 PA Practitioner - Internal Medicine 6507055456 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

830 Old Lancaster Rd
Bryn Mawr, PA 19010-3118

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pottstown Clinic Company LLC Internal Medicine CurrentSince Jul 11, 2011 Accepting new patients
Main Line Healthcare Internal Medicine CurrentSince Jul 1, 2013 Accepting new patients

Locations

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

950 Forge Ave
#200
Norristown, PA 19403
Phone (484) 956-6000

730 S Hanover St
Pottstown, PA 19465
Phone (610) 323-6835

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424649600000",
    "number": "1447414453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 FORGE AVE",
            "address_2": "SUITE 200",
            "city": "AUDUBON",
            "state": "PA",
            "postal_code": "194032305",
            "telephone_number": "484-956-6000",
            "fax_number": "484-956-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 FORGE AVE",
            "address_2": "SUITE 200",
            "city": "AUDUBON",
            "state": "PA",
            "postal_code": "194032305",
            "telephone_number": "484-956-6000",
            "fax_number": "484-956-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIGLIOTTA",
        "first_name": "GRAHAM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-18",
        "last_updated": "2015-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS015096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Audubon, PA

Sources for this page

Verify at the official NPI Registry.