Gordon Ijelu, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

MD044243E Issued in PA

Practice address

6329 N Broad St
Philadelphia, PA 19141-2009

Phone

(215) 924-2244

Fax

(215) 924-2228

NPI assigned

May 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Internal MedicineAlso: Nephrology

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Einstein Philadelphia Hospital Hospital, Philadelphia, PA, CCN 390142

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gordon.ijelu@gordonmedicalassociatespc.chartmakerdirect.com

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.

• Gordon Medical Associates PC

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1962456103
  Medicare reassignment NPD Authorized official
• Genmed LLC

  • Physiological Laboratory
  • Hickory, PA
  • NPI 1306592787
  Medicare reassignment NPD
• Encompass Remote Inc

  • Physiological Laboratory
  • Canonsburg, PA
  • NPI 1063105559
  NPD

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

• Einstein Hospital

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1366653818
  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355443200000",
    "number": "1841244027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 MUIRFIELD DR",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194221295",
            "telephone_number": "215-924-2244",
            "fax_number": "215-924-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6329 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191412009",
            "telephone_number": "215-924-2244",
            "fax_number": "215-924-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IJELU",
        "first_name": "GORDON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2012-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD044243E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1243184",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ihome Care Incorporated
• Ihp PA Emergency Medicine PLLC
• III Kings Inc.
• Heba Ijaz, MD
• Chinye Ijeli, MD
• Ijmedcare LLC
• Trish Ike-Omotowa, MD
• Dana Ikeda, RDN, LDN
• Kirstin Ikeda, MS OTR/L
• Okwuolisa Amechi Ikediobi, M.D.

• Nephrology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Nephrology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2012; 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.