Juan Jose Gan, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD436963 Issued in PA

Practice address

130 S Bryn Mawr Ave Ste 160
Bryn Mawr, PA 19010-3121

Phone

(484) 337-1286

NPI assigned

May 11, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, RI2 enrollments

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 2

Specialty

Psychiatry

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Nurowav TMS PCGroup PAC ID 9133587470, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riddle Memorial Hospital Hospital, Media, PA, CCN 390222
• Paoli Hospital Hospital, Paoli, PA, CCN 390153

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 26)

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment Care Compare group NPD
• Nurowav TMS PC

  • Psychiatry Physician
  • Langhorne, PA
  • NPI 1457054975
  Medicare reassignment Care Compare group NPD
• American Treatment Network LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Havertown, PA
  • NPI 1871182451
  Medicare reassignment NPD
• DLP Conemaugh Physician Practices LLC

  • Family Medicine Physician
  • Cresson, PA
  • NPI 1932515905
  Medicare reassignment NPD
• Prospect Health Access Network, Inc.

  • Emergency Medicine Physician
  • Chester, PA
  • NPI 1568819084
  Medicare reassignment NPD
• Resources for Human Development, Inc.

  • Community/Behavioral Health Agency
  • Bryn Mawr, PA
  • NPI 1548395585
  Medicare reassignment NPD
• Prospect Chartercare RWMC, LLC

  • Internal Medicine Physician
  • Providence, RI
  • NPI 1285059287
  Medicare reassignment NPD
• Prospect Chartercare Sjhsri, LLC

  • Internal Medicine Physician
  • North Providence, RI
  • NPI 1588089759

  Psychiatry

  Medicare reassignment NPD
• DLP Conemaugh Physician Practices LLC

  • Family Medicine Physician
  • Somerset, PA
  • NPI 1164838512
  NPD
• DLP Conemaugh Physician Practices LLC

  • Internal Medicine Physician
  • Johnstown, PA
  • NPI 1205242609
  NPD
• Family Practice & Counseling Services Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1689357782
  NPD
• Prospect Health Access Network, Inc.

  • Diagnostic Radiology Physician
  • Chester, PA
  • NPI 1154776797
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Main Line Hospitals, Inc.

  • General Acute Care Hospital
  • Paoli, PA
  • NPI 1215042114
  Care Compare affiliation
• Riddle Memorial Hospital

  • General Acute Care Hospital
  • Media, PA
  • NPI 1407856099
  Care Compare affiliation

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1801001136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 W CHESTER PIKE STE 160",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732336",
            "telephone_number": "484-337-1286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S BRYN MAWR AVE STE 160",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103121",
            "telephone_number": "484-337-1286"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Blvd",
            "address_2": "Crozer Chester Medical Dept of Psych, POB 1, suite 407,",
            "address_purpose": "LOCATION",
            "city": "Chester",
            "state": "PA",
            "postal_code": "190133902",
            "country_code": "US",
            "telephone_number": "610-447-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAN",
        "first_name": "JUAN",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MT187199",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD436963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Functional Performance Physical Therapy, LLC
• Christopher Ryan Fung, DPM
• Heather Gallagher, MSN CRNP
• Nina Rose Gallimore, PA-C
• Nancy Gambescia, PH.D.
• Parth Gandhi, DO
• Maria Celeste Gannett, CRNP
• Ildiko Maria Gardner, OTRL
• John Anthony Garofalo, MD
• Sandra J. Garrison, APN

• Psychiatry Physician in Bryn Mawr, PA
• Providers in Bryn Mawr, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.