Individual provider Active NPI

Kevin A Gingrich, MD

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1861482424
Registry record updated Nov 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
MD040220E Issued in PA
Practice address
216-220 N. Broad Street
2ND Floor Feinstein Building
Philadelphia, PA 19102-1121
Phone
(215) 762-2663
Fax
(215) 762-4447
NPI assigned
Oct 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X MD040220E PA Primary

Addresses

Primary practice location

216-220 N. Broad Street
2ND Floor Feinstein Building
Philadelphia, PA 19102-1121

Mailing address

230 N Broad St
Philadelphia, PA 19102-1121
Phone (215) 255-3828

Other identifiers 1

IdentifierTypeStateIssuer
12512750008MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20200316001952 GA Practitioner - Orthopedic Surgery 7416912498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Hahneman Medical College of the Pacific, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedics Sports Medicine and Surgery LLCGroup PAC ID 1355504465, 3 clinicians

Practice addresses (Care Compare)

612 W Gordon St
Thomaston, GA 30286-3480
Phone (706) 647-3030

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Removal of tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedics Sports Medicine & Surgery, LLC CurrentSince Oct 14, 2019 Accepting new patients

Locations

100 Highway 18 W
Ste 206
Barnesville, GA 30204
Phone (770) 358-1860

612 W Gordon St
Thomaston, GA 30286
Phone (706) 647-3030

801 W Gordon St
Thomaston, GA 30286
Phone (706) 647-4371

612 W Gordon St
Ste E
Thomaston, GA 30286
Phone (706) 647-3030

Organizations & group practices 1

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 4

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": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447286400000",
    "number": "1861482424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021121",
            "telephone_number": "215-255-3828",
            "fax_number": "215-255-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216-220 N. BROAD STREET",
            "address_2": "2ND FLOOR FEINSTEIN BUILDING",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021121",
            "telephone_number": "215-762-2663",
            "fax_number": "215-762-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINGRICH",
        "first_name": "KEVIN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2015-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "PA",
            "license": "MD040220E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12512750008",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.