Individual provider Active NPI

Spiridon Nicholas Vonortas, MD, MPH

  • Pediatrics Physician
  • Bryn Mawr, PA
National Provider Identifier
1720738248
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD490482 Issued in PA
Practice address
663 W Lancaster Ave
Bryn Mawr, PA 19010-3805
Phone
(610) 658-0999
NPI assigned
Mar 27, 2022
Last updated
Jul 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X MD490482 PA Primary

Addresses

Primary practice location

663 W Lancaster Ave
Bryn Mawr, PA 19010-3805

Mailing address

6768 Brigadoon Dr
Bethesda, MD 20817-5436
Phone (240) 408-1929

Other practice location 1

1215 Lee St Box '800501'
Charlottesville, VA 22908-0816
Phone (434) 924-5321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20220713000995 VA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 3971984618

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD490482PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital of Philadelphia Pediatrics Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1648339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1720738248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6768 BRIGADOON DR",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208175436",
            "telephone_number": "240-408-1929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "663 W LANCASTER AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103805",
            "telephone_number": "610-658-0999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St Box '800501'",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080816",
            "country_code": "US",
            "telephone_number": "434-924-5321",
            "fax_number": "434-982-3816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VONORTAS",
        "first_name": "SPIRIDON",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-27",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD490482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.