NPIMap

Individual provider Active NPI

Nikhilesh M Korgaonkar, MD, MBA

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • York, PA
National Provider Identifier
1609089580
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MD453445 Issued in PA
Practice address
25 Monument Rd Ste 295
York, PA 17403-5049
Phone
(717) 356-5864
Fax
(717) 409-6221
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X D69375 MD
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD453445 PA Primary
Surgery Physician 208600000X D0069375 MD
Surgery Physician 208600000X MD453445 PA
Surgery Physician 208600000X 235025 NY

Addresses

Primary practice location

25 Monument Rd Ste 295
York, PA 17403-5049

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 356-5864

Other identifiers 1

IdentifierTypeStateIssuer
102989705MedicaidPA

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
I20150128001331 PA Practitioner - Thoracic SurgeryPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Cardiac Surgery 2163576547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: Cardiac Surgery, Cardiovascular Disease (Cardiology)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

1001 S George St
York, PA 17403-3676

1001 S George St 2ND Floor
Wellspan Pulmonary and Sleep Medicine
York, PA 17403-3676
Phone (717) 851-2465

25 Monument Rd
York, PA 17403-5049

25 Monument Rd
York, PA 17403-5073

2618 E Market St
Autumn House
York, PA 17403
Phone (717) 845-7214

40 V Twin Dr
Gettysburg, PA 17325-7878

914 W Market St
Autumn House West
York, PA 17403
Phone (717) 845-7214

Hospital & facility affiliations

  • Wellspan Vna Home Care Home health agency, York, PA, CCN 397004
  • Wellspan York Hospital Hospital, York, PA, CCN 390046
  • Gettysburg Hospital Hospital, Gettysburg, PA, CCN 390065
  • Wellspan Chambersburg Hospital Hospital, Chambersburg, PA, CCN 390151
  • Wellspan Waynesboro Hospital Hospital, Waynesboro, PA, CCN 390138
  • Upmc Hanover Hospital, Hanover, PA, CCN 390233

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
235025NYMDSurgery Physician
D69375MDMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MD453445PAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Jan 26, 2015 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince Jan 26, 2015 Accepting new patients
York Hospital Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 190
York, PA 17403
Phone (717) 741-8011

25 Monument Rd
Ste 295
York, PA 17403
Phone (717) 356-5864

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

Interoperability endpoints

  • Direct secure messaging: nkorgaonkar14122@wellspan.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1609089580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-356-5864",
            "fax_number": "717-409-6221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MONUMENT RD STE 295",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174035049",
            "telephone_number": "717-356-5864",
            "fax_number": "717-409-6221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORGAONKAR",
        "first_name": "NIKHILESH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MD",
            "license": "D69375",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PA",
            "license": "MD453445",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D0069375",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD453445",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "235025",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102989705",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.