Individual provider Active NPI

Peter Michael Gdovin, PA-C

  • Surgical Physician Assistant
  • Pennington, NJ
National Provider Identifier
1538530597
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00380500 Issued in NJ
Practice address
2 Capital Way Ste 456
Pennington, NJ 08534-2521
Phone
(609) 537-7300
NPI assigned
Oct 15, 2015
Last updated
Oct 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00380500 NJ
Medical Physician Assistant 363AM0700X MA058164 PA
Surgical Physician Assistant 363AS0400X 25MP00380500 NJ Primary

Addresses

Primary practice location

2 Capital Way Ste 456
Pennington, NJ 08534-2521

Mailing address

2 Capital Way Ste 456
Pennington, NJ 08534-2521
Phone (609) 537-7300

Other practice location 1

750 Brunswick Ave
Trenton, NJ 08638-4143
Phone (609) 394-6000

Other practice location 2

3 Penns Trl Fl 2
Newtown, PA 18940-1812
Phone (609) 537-7300

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address Peter.Gdovin@capitalhealth.cernerdirect.com Direct
Direct Messaging Address peter.gdovin.1@12833.direct.athenahealth.com Direct
Direct Messaging Address peter.gdovin.1@12833.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160114001154 NJ Practitioner - Physician Assistant 3173826781 Reassigns benefits to 2 organizations
I20241016004886 PA Practitioner - Physician Assistant 3173826781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Health Multispecialty GroupGroup PAC ID 1850689894, 342 clinicians
Capital Health Medical GroupGroup PAC ID 7618264532, 442 clinicians

Practice addresses (Care Compare)

1 Capital Way
Pennington, NJ 08534-2520
Phone (609) 303-4000

1050 Stony Hill Rd
Yardley, PA 19067-5500
Phone (215) 504-1761

3 Penns TRL
Newtown, PA 18940-1812
Phone (215) 504-1761

3120 Princeton Pike
Suite 21
Lawrenceville, NJ 08648-2325
Phone (609) 896-1701

750 Brunswick Ave
Trenton, NJ 08638-4143
Phone (609) 394-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00380500NJMDPhysician Assistant
MA058164PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Women's Specialists of Bucks County, P.C. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2126/brand/1/csg/1/fhir/r4
  • Direct secure messaging: peter.gdovin.1@12833.direct.athenahealth.com
  • Direct secure messaging: peter.gdovin@capitalhealth.cernerdirect.com

Organizations & group practices 3

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 4

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": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1538530597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CAPITAL WAY STE 456",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085342521",
            "telephone_number": "609-537-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CAPITAL WAY STE 456",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085342521",
            "telephone_number": "609-537-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 Brunswick Ave",
            "address_purpose": "LOCATION",
            "city": "Trenton",
            "state": "NJ",
            "postal_code": "086384143",
            "country_code": "US",
            "telephone_number": "609-394-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 Penns Trl Fl 2",
            "address_purpose": "LOCATION",
            "city": "Newtown",
            "state": "PA",
            "postal_code": "189401812",
            "country_code": "US",
            "telephone_number": "609-537-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GDOVIN",
        "first_name": "PETER",
        "middle_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-15",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00380500",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA058164",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00380500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Peter.Gdovin@capitalhealth.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "750 Brunswick Ave",
            "city": "Trenton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "086384143",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "peter.gdovin.1@12833.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2 Capital Way Ste 456",
            "city": "Pennington",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "085342521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "peter.gdovin.1@12833.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3 Penns Trl Fl 2",
            "city": "Newtown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "189401812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pennington, NJ

Sources for this page

Verify at the official NPI Registry.