Andrew G Bongiovanni, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS003771L Issued in PA

Practice address

1991 Sproul Rd
Suite 450
Broomall, PA 19008-3512

Phone

(484) 427-8999

Fax

(484) 421-3001

NPI assigned

May 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

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

  Internal Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430438400000",
    "number": "1811949191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 SPROUL RD",
            "address_2": "SUITE 450",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083512",
            "telephone_number": "484-427-8999",
            "fax_number": "484-421-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 SPROUL RD",
            "address_2": "SUITE 450",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083512",
            "telephone_number": "484-427-8999",
            "fax_number": "484-421-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONGIOVANNI",
        "first_name": "ANDREW",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2015-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS003771L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Twinkle S Bhalodia, CRNP
• Seth M. Blitzer, DMD
• Blossom Home Care LLC
• Stephanie Marie Bodnar, RD, LDN
• Jeffrey Bomze, MD
• Jessica Bordas, BT
• Andrew Jeffrey Borson, PH.D.
• Linda Simone Borson, M.ED.
• John Boschetti, D.O.
• Mary E Bove, MD

• Internal Medicine Physician in Broomall, PA
• Providers in Broomall, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.