Individual provider Active NPI

Matthew Joel Nagorsky, MD

  • Otolaryngology Physician
  • Philadelphia, PA
National Provider Identifier
1780655738
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD043861E Issued in PA
Practice address
205 N Broad St
Suite 401
Philadelphia, PA 19107-1554
Phone
(215) 762-4600
Fax
(215) 988-0733
NPI assigned
Jan 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD043861E PA Primary

Addresses

Primary practice location

205 N Broad St
Suite 401
Philadelphia, PA 19107-1554

Mailing address

205 N Broad St
Suite 401
Philadelphia, PA 19107-1554
Phone (215) 762-4600

Other identifiers 1

IdentifierTypeStateIssuer
0011689100004MedicaidPA

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
I20110607000719 PA Practitioner - Otolaryngology 5991721755 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Virginia School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Otolaryngology Associates PCGroup PAC ID 0941299895, 9 clinicians

Practice addresses (Care Compare)

205 N Broad St
Suite 401
Philadelphia, PA 19107-1553
Phone (215) 762-4600

210 Mall Blvd
Suite 202
King of Prussia, PA 19406-3260
Phone (484) 681-9009

5501 Old York Rd
Phila, PA 19141-3018
Phone (215) 456-7140

8350 Roosevelt Blvd
Philadelphia, PA 19152-2531
Phone (215) 331-6878

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD043861EPAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fornance Physician Services, Inc. CurrentSince Mar 1, 2021 Accepting new patients
University Otolaryngology Associates PC Otolaryngology CurrentSince Jul 6, 1990 Accepting new patients
Fornance Physician Services Inc CurrentSince Mar 1, 2021 Accepting new patients
Fornance Physician Services, Inc Current Accepting new patients

Locations

210 Mall Blvd
Ste 202
King of Prussia, PA 19406
Phone (484) 557-3260

210 Mall Blvd
Ste 102
Kng of Prussa, PA 19406
Phone (610) 265-0726

5501 Old York Rd
Ste 2
Philadelphia, PA 19141
Phone (215) 456-7130

205 N Broad St
Ste 401
Philadelphia, PA 19107
Phone (215) 569-3155

8350 Roosevelt Blvd
Philadelphia, PA 19152
Phone (215) 331-6878

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 and National Provider Directory roles.

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": "1138492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1780655738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N BROAD ST",
            "address_2": "SUITE 401",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071554",
            "telephone_number": "215-762-4600",
            "fax_number": "215-988-0733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N BROAD ST",
            "address_2": "SUITE 401",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071554",
            "telephone_number": "215-762-4600",
            "fax_number": "215-988-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGORSKY",
        "first_name": "MATTHEW",
        "middle_name": "JOEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-29",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD043861E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011689100004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.