NPIMap

Organization Active NPI

Ear Nose Throat Facial Plastic Surgery Specialists PC

  • Otolaryngology Physician
  • Willow Grove, PA
National Provider Identifier
1780016360
Registry record updated Aug 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
EAR NOSE THROAT FACIAL PLASTIC SURGERY SPECIALISTS PC
Practice address
723 Fitzwatertown Rd
Willow Grove, PA 19090-1337
Phone
(215) 659-8805
NPI assigned
Aug 6, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2013

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

Authorized official

Name
Joshua E Goldberg, DONPI 1962425520
Title
President
Phone
(215) 659-8805

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

723 Fitzwatertown Rd
Willow Grove, PA 19090-1337

Mailing address

723 Fitzwatertown Rd
Willow Grove, PA 19090-1337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131202000499 PA Part B Supplier - Clinic/Group Practice 2769618495 Receives reassigned benefits from 5 practitioners
Practice locations: Warminster, PA; Willow Grove, PA

National Provider Directory

National Provider Directory

Locations

723 Fitzwatertown Rd
Willow Grove, PA 19090
Phone (215) 659-8805

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1375747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375747200000",
    "number": "1780016360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 FITZWATERTOWN RD",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 FITZWATERTOWN RD",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901337",
            "telephone_number": "215-659-8805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR NOSE THROAT FACIAL PLASTIC SURGERY SPECIALISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-06",
        "last_updated": "2013-08-06",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-659-8805",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Grove, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.