NPIMap

Organization Active NPI

University Otolaryngology Associates PC

  • Otolaryngology Physician
  • Philadelphia, PA
National Provider Identifier
1457315715
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
UNIVERSITY OTOLARYNGOLOGY ASSOCIATES PC
Practice address
205 N Broad St
Suite 401
Philadelphia, PA 19107-1554
Phone
(215) 762-4600
Fax
(215) 988-0733
NPI assigned
Apr 13, 2006
Last updated
Feb 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Authorized official

Name
Matthew Joel Nagorsky, MDNPI 1780655738
Title
President
Phone
(215) 762-4600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Y00000X Primary
Otolaryngic Allergy PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207YX0602X

Addresses

Primary practice location

205 N Broad St
Suite 401
Philadelphia, PA 19107-1554

Mailing address

205 N Broad St
Suite 401
Philadelphia, PA 19107-1554
Phone (215) 762-4600

Other identifiers 2

IdentifierTypeStateIssuer
0018866300MedicaidPA
CG0580OtherPARAIL ROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040507000154 PA Part B Supplier - Clinic/Group Practice 0941299895 Receives reassigned benefits from 16 practitioners
Practice locations: Philadelphia, PA; King of Prussia, PA

National Provider Directory

National Provider Directory

Locations

1331 E Wyoming Ave
Ste 2120
Phila, PA 19124
Phone (215) 743-9300

1740 South St
#2
Philadelphia, PA 19146
Phone (215) 568-8040

205 N Broad St
Ste 401
Philadelphia, PA 19107
Phone (215) 569-3155

5501 Old York Rd
Ste 2361
Philadelphia, PA 19141

8350 Roosevelt Blvd
Philadelphia, PA 19152
Phone (215) 331-6878

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580688000000",
    "number": "1457315715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N BROAD ST",
            "address_2": "SUITE 401",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071554",
            "telephone_number": "215-762-4600",
            "fax_number": "215-988-0733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N BROAD ST",
            "address_2": "SUITE 401",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071554",
            "telephone_number": "215-762-4600",
            "fax_number": "215-988-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OTOLARYNGOLOGY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-13",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A",
        "authorized_official_last_name": "NAGORSKY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "JOEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-762-4600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018866300",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "CG0580",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.