Active NPI
Ronald C Goren, M.D.
- Infectious Disease Physician
- Phila, PA
National Provider Identifier
1912986373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- MD022684E
- Practice address
- 9501 Roosevelt Blvd
Suite 208
Phila, PA 19114-1025 - Phone
- (215) 464-9634
- Fax
- (215) 969-2327
- NPI assigned
- Jan 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | MD022684E | PA | Primary |
Addresses
Primary practice location
9501 Roosevelt Blvd
Suite 208
Phila, PA 19114-1025
Mailing address
9501 Roosevelt Blvd
Suite 208
Phila, PA 19114-1025
Phone (215) 464-9634
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00730035 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD022684E | PA | MD | Infectious Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407888000000",
"number": "1912986373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9501 ROOSEVELT BLVD",
"address_2": "SUITE 208",
"city": "PHILA",
"state": "PA",
"postal_code": "191141025",
"telephone_number": "215-464-9634",
"fax_number": "215-969-2327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9501 ROOSEVELT BLVD",
"address_2": "SUITE 208",
"city": "PHILA",
"state": "PA",
"postal_code": "191141025",
"telephone_number": "215-464-9634",
"fax_number": "215-969-2327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOREN",
"first_name": "RONALD",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-13",
"last_updated": "2014-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "PA",
"license": "MD022684E",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00730035",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phila, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.