Individual provider Active NPI

Jonathan D Gomberg, MD

  • Cardiovascular Disease Physician
  • Philadelphia, PA
National Provider Identifier
1780658237
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD029380E Issued in PA
Practice address
3400 Civic Center Boulevard
East Pavilion, 2ND Floor
Philadelphia, PA 19104-4306
Phone
(215) 615-4949
Fax
(215) 615-0829
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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 MD029380E PA Primary

Addresses

Primary practice location

3400 Civic Center Boulevard
East Pavilion, 2ND Floor
Philadelphia, PA 19104-4306

Mailing address

3400 Civic Center Boulevard
East Pavilion, 2ND Floor
Philadelphia, PA 19104-4306
Phone (215) 615-4949

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
I20040223000785 PA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3779479266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Medical College of Pennsylvania, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Civic Ctr Blvd
Philadelphia, PA 19104-5127
Phone (215) 615-4949

3400 Civic Ctr Blvd W Pavillion
Penn Vad Transplant Perelman
Philadelphia, PA 19104-5127
Phone (215) 662-2019

51 N 39TH St
Philadelphia, PA 19104-2640
Phone (215) 662-9801

51 N 39TH St HVP 2ND FL
Div of Cardiology
Philadelphia, PA 19104-2640
Phone (215) 662-9010

Hospital & facility affiliations

  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Cardiovascular Disease CurrentSince Jan 1, 2007 Accepting new patients
University of Penn-Medical Group CurrentSince Jan 1, 2007 Accepting new patients

Locations

3400 Civic Center Blvd
Ste 2E
Philadelphia, PA 19104
Phone (215) 615-0820

8835 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8227

51 N 39th St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-9010

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

250 King of Prussia Rd
Radnor, PA 19087
Phone (610) 902-1800

Organizations & group practices 2

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 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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1780658237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BOULEVARD",
            "address_2": "EAST PAVILION, 2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044306",
            "telephone_number": "215-615-4949",
            "fax_number": "215-615-0829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BOULEVARD",
            "address_2": "EAST PAVILION, 2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044306",
            "telephone_number": "215-615-4949",
            "fax_number": "215-615-0829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMBERG",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD029380E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.