Individual provider Active NPI

Amar Gautam Nanavati, M.D.

  • Hospitalist Physician
  • Philadelphia, PA
National Provider Identifier
1871756791
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
25MA09165900 Issued in NJ
Practice address
1360 West Ontario Street
Jones Hall 9TH Floor
Philadelphia, PA 19140
Phone
(609) 320-7856
NPI assigned
Jul 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 25MA09165900 NJ Primary
Internal Medicine Physician 207R00000X MD443502 PA

Addresses

Primary practice location

1360 West Ontario Street
Jones Hall 9TH Floor
Philadelphia, PA 19140

Mailing address

1360 West Ontario Street
Jones Hall 9TH Floor
Philadelphia, PA 19140
Phone (609) 320-7856

Other practice location 1

90 Brick Rd
Marlton, NJ 08053-2177
Phone (856) 355-6000

Other practice location 2

175 Madison Ave
Mount Holly, NJ 08060-2099
Phone (609) 914-6000

Other practice location 3

100 Bowman Dr
Voorhees, NJ 08043-9612
Phone (856) 247-3000

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address ananavati18714@directvirtua.org
Direct Messaging Address ananavati18714@directvirtua.org
Direct Messaging Address ananavati18714@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 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

Enrollment IDStateProvider typePAC IDDetails
I20111109000092 PA Practitioner - Internal Medicine 1658544564 Reassigns benefits to 1 organization
I20140110000151 NJ Practitioner - Internal Medicine 1658544564 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

175 Madison Ave
Mount Holly, NJ 08060-2038

3242 Route 206
Bordentown, NJ 08505-4517

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD443502PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare , LLC Internal Medicine CurrentSince Jul 27, 2012 Accepting new patients
University of Penn-Medical Group CurrentSince Jan 1, 2023 Accepting new patients
Advocare, LLC Internal Medicine CurrentSince Jul 27, 2012 Accepting new patients
Virtua Medical Group, PA CurrentSince Oct 21, 2013 Accepting new patients
University of Penn - Medical Group Internal Medicine CurrentSince Jan 1, 2023 Accepting new patients
Virtua Medical Group, PA Internal Medicine CurrentSince Oct 21, 2013 Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients
University of Penn - Medical Group Past Accepting new patients
Cogent Healthcare of Pennsylvania, Inc. Internal Medicine Past Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

90 Brick Rd
Marlton, NJ 08053
Phone (856) 355-6040

175 Madison Ave
Mount Holly, NJ 08060
Phone (609) 261-1660

7000 Atrium Way
Ste 6
Mount Laurel, NJ 08054
Phone (856) 206-4500

100 Bowman Dr
Voorhees, NJ 08043
Phone (856) 247-3000

Interoperability endpoints

  • Direct secure messaging: ananavati18714@directvirtua.org

Organizations & group practices 9

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 3

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": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1871756791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 WEST ONTARIO STREET",
            "address_2": "JONES HALL 9TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19140",
            "telephone_number": "609-320-7856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 WEST ONTARIO STREET",
            "address_2": "JONES HALL 9TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19140",
            "telephone_number": "609-320-7856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "90 Brick Rd",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080532177",
            "country_code": "US",
            "telephone_number": "856-355-6000",
            "fax_number": "856-355-6731",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "175 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Mount Holly",
            "state": "NJ",
            "postal_code": "080602099",
            "country_code": "US",
            "telephone_number": "609-914-6000",
            "fax_number": "609-914-6182",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Bowman Dr",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080439612",
            "country_code": "US",
            "telephone_number": "856-247-3000",
            "fax_number": "856-247-2597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NANAVATI",
        "first_name": "AMAR",
        "middle_name": "GAUTAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-10",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NJ",
            "license": "25MA09165900",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD443502",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ananavati18714@directvirtua.org",
            "affiliation": "N",
            "address_1": "175 Madison Ave",
            "city": "Mount Holly",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080602099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ananavati18714@directvirtua.org",
            "affiliation": "N",
            "address_1": "90 Brick Rd",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080532177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ananavati18714@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Bowman Dr",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.