NPIMap

Individual provider Active NPI

Ian Dennis Holgado, DO

  • Family Medicine Physician
  • Exton, PA
National Provider Identifier
1790723443
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS012508 Issued in PA
Practice address
93 W Devon Dr
Suite 100
Exton, PA 19341-3062
Phone
(610) 321-0200
Fax
(610) 594-2625
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS012508 PA Primary

Addresses

Primary practice location

93 W Devon Dr
Suite 100
Exton, PA 19341-3062

Mailing address

412 Creamery Way
Suite 400
Exton, PA 19341-2551
Phone (610) 594-7590

Other identifiers 1

IdentifierTypeStateIssuer
102434521MedicaidPA

Other names 1

  • I. Dennis Holgado Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040430000468 PA Practitioner - Family Practice 5991792822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pentahealth, LLCGroup PAC ID 9537586672, 67 clinicians

Practice addresses (Care Compare)

93 W Devon Dr
100 Gateway Medical Associates PC
Exton, PA 19341-3008
Phone (610) 321-0200

Hospital & facility affiliations

  • Penn Medicine Home Health Home health agency, Bala Cynwyd, PA, CCN 397125
  • Main Line Health Home Care & Hospice - Home Health Home health agency, Radnor, PA, CCN 397012
  • Chester County Hospital Hospital, West Chester, PA, CCN 390179
  • Paoli Hospital Hospital, Paoli, PA, CCN 390153
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Riddle Memorial Hospital Hospital, Media, PA, CCN 390222
  • Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
  • Bryn Mawr Rehabilitation Hospital Inpatient rehabilitation facility, Malvern, PA, CCN 393025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS012508PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pentahealth, LLC Family Medicine CurrentSince Oct 1, 2020 Accepting new patients
Westtown Valley Medical Associates, PC Family Medicine Past Accepting new patients

Locations

412 Creamery Way
Ste 400
Exton, PA 19341
Phone (610) 269-9448

93 W Devon Dr
Ste 100
Exton, PA 19341
Phone (610) 321-0200

520 Maple Ave
Ste 4
West Chester, PA 19380
Phone (610) 430-8200

Interoperability endpoints

  • Direct secure messaging: idennisholgado@gmacc.allscriptsdirect.net

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 8

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1790723443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 CREAMERY WAY",
            "address_2": "SUITE 400",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193412551",
            "telephone_number": "610-594-7590",
            "fax_number": "610-594-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 W DEVON DR",
            "address_2": "SUITE 100",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193413062",
            "telephone_number": "610-321-0200",
            "fax_number": "610-594-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLGADO",
        "first_name": "IAN",
        "middle_name": "DENNIS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS012508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102434521",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "I. DENNIS",
            "last_name": "HOLGADO",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Exton, PA

Sources for this page

Verify at the official NPI Registry.