Joseph F. Mambu, MD PC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

MD017725E Issued in PA

Legal business name

JOSEPH F. MAMBU, MD PC

Doing business as

Family Medicine, Geriatrics & Wellness

Practice address

714 N Bethlehem Pike
Ste 101
Lower Gwynedd, PA 19002-2655

Phone

(215) 540-4411

Fax

(215) 540-4415

NPI assigned

Jun 24, 2005

Organization subpart

No

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

Authorized official

Name

Joseph F Mambu, M.D.NPI 1518961408

Title

President

Phone

(215) 540-4411

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Family Medicine, Geriatrics & Wellness Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joseph F Mambu, MD

  • Family Medicine Physician
  • Lower Gwynedd, PA
  • NPI 1518961408
  Medicare reassignment Authorized official
• Jorge M Diduszyn, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Camp Hill, PA
  • NPI 1073574257
  NPD (past)
• Niccole M Oswald, MD

  • Family Medicine Physician
  • Silverdale, PA
  • NPI 1285628180
  NPD (past)
• Daila Melita Pravs, M.D.

  • Family Medicine Physician
  • Wyndmoor, PA
  • NPI 1598980724
  NPD (past)

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1851397731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 N BETHLEHEM PIKE",
            "address_2": "STE 101",
            "city": "LOWER GWYNEDD",
            "state": "PA",
            "postal_code": "190022655",
            "telephone_number": "215-540-4411",
            "fax_number": "215-540-4415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 N BETHLEHEM PIKE",
            "address_2": "STE 101",
            "city": "LOWER GWYNEDD",
            "state": "PA",
            "postal_code": "190022655",
            "telephone_number": "215-540-4411",
            "fax_number": "215-540-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH F. MAMBU, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-24",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "MAMBU",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-540-4411",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "PA",
            "license": "MD017725E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-PA KEYSTONE",
            "identifier": "0864515001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-PA HIGHMARK",
            "identifier": "921651",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medicine, Geriatrics & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alana Gregg, MS
• Dorothea Joan Haines, R.N.
• Susan O. Hohenadel, R.D.,C.D.E.,L.D.N.
• Madalyn Hungate, MA
• Randall N. Hyer, M.D., PH.D., M.P.H.
• Helen Marita Kane, MS, RD, LDN
• Genevieve M Kim, MA MFT
• Jieun Kim, M.D.
• Stacie R Kisver, RD
• Jean Kriebel, PTA

• Geriatric Medicine (Family Medicine) Physician in Lower Gwynedd, PA
• Providers in Lower Gwynedd, PA by specialty
• Geriatric Medicine (Family Medicine) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.