Individual provider Active NPI

Paulina Gorodin, MD

  • Cardiovascular Disease Physician
  • Philadelphia, PA
National Provider Identifier
1609821446
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD422068 Issued in PA
Practice address
925 Chestnut St
Philadelphia, PA 19107-4216
Phone
(215) 955-5050
NPI assigned
May 23, 2006
Last updated
Feb 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD422068 PA Primary

Addresses

Primary practice location

925 Chestnut St
Philadelphia, PA 19107-4216

Mailing address

1601 Cherry St
Suite 11511
Phila, PA 19102-1320
Phone (215) 255-7822

Other practice location 1

245 N 15th St
ms 470
Phila, PA 19102-1101
Phone (215) 762-7241

Other identifiers 1

IdentifierTypeStateIssuer
05953963OtherECFMG

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060721000061 PA Practitioner - Cardiovascular Disease (Cardiology) 1850304650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

925 Chestnut St
Mezzanine
Philadelphia, PA 19107-4290
Phone (215) 955-5050

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince Jan 27, 2020 Accepting new patients
Jefferson University Physicians Past Accepting new patients
Thomas Jefferson University Hospitals Inc Past Accepting new patients
Philadelphia Health & Education Corp Cardiovascular Disease Past Accepting new patients

Locations

111 S 11th St
Philadelphia, PA 19107
Phone (215) 955-6161

925 Chestnut St
Philadelphia, PA 19107
Phone (215) 955-5050

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 4

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 2

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1609821446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CHERRY ST",
            "address_2": "SUITE 11511",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191021320",
            "telephone_number": "215-255-7822",
            "fax_number": "215-255-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074216",
            "telephone_number": "215-955-5050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 N 15th St",
            "address_2": "ms 470",
            "address_purpose": "LOCATION",
            "city": "Phila",
            "state": "PA",
            "postal_code": "191021101",
            "country_code": "US",
            "telephone_number": "215-762-7241",
            "fax_number": "215-246-5322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORODIN",
        "first_name": "PAULINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD422068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ECFMG",
            "identifier": "05953963",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.