Bruce Kornberg, DO

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

OS004228L Issued in PA

Practice address

100 East Lancaster Avenue
JD Lankenau Pavilion, Mezzanine
Wynnewood, PA 19096-3450

Phone

(484) 476-1000

Fax

(484) 476-9000

NPI assigned

Feb 13, 2006

Last updated

Feb 13, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Cardiovascular Disease (Cardiology)

Education

Philadelphia College of Osteopathic Medicine, 1978

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)

Hospital & facility affiliations

• Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
• Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
• Riddle Memorial Hospital Hospital, Media, PA, CCN 390222

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment Care Compare group NPD
• Delaware Valley Medical Specialties

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1013016716
  NPD (past)

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

• Main Line Hospitals, Inc.

  dba Lankenau Hospital

  • General Acute Care Hospital
  • Wynnewood, PA
  • NPI 1245335629
  Care Compare affiliation
• Main Line Hospitals, Inc.

  dba Bryn Mawr Hospital

  • General Acute Care Hospital
  • Bryn Mawr, PA
  • NPI 1508971441
  Care Compare affiliation
• Riddle Memorial Hospital

  • General Acute Care Hospital
  • Media, PA
  • NPI 1407856099
  Care Compare affiliation

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518480000000",
    "number": "1487627055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-476-1000",
            "fax_number": "484-476-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EAST LANCASTER AVENUE",
            "address_2": "JD LANKENAU PAVILION, MEZZANINE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-476-1000",
            "fax_number": "484-476-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNBERG",
        "first_name": "BRUCE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2018-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "OS004228L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grant Knoll, MD
• Tamika Knox, LCSW
• Sravya Koduri
• Julia Rose Kompare
• Drew Anthony Kopicki
• Lauren A Kosinski, MD
• Matthew John Koury
• Kelly Claire Kovacik, MD
• Ryan Edward Kovacik
• Eva Kovacs, M.D

• Cardiovascular Disease Physician in Wynnewood, PA
• Providers in Wynnewood, PA by specialty
• Cardiovascular Disease Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.