Individual provider Active NPI

Gregory Mark Closkey, M.D.

  • Nephrology Physician
  • Bryn Mawr, PA
National Provider Identifier
1942223573
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD038267L Issued in PA
Practice address
830 Old Lancaster Rd
Suite 206
Bryn Mawr, PA 19010-3118
Phone
(610) 525-8110
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD038267L PA Primary

Addresses

Primary practice location

830 Old Lancaster Rd
Suite 206
Bryn Mawr, PA 19010-3118

Mailing address

830 Old Lancaster Rd
Suite 206
Bryn Mawr, PA 19010-3118
Phone (610) 525-8110

Other identifiers 4

IdentifierTypeStateIssuer
098735OtherPABLUE SHIELD
0012981000002OtherPAPROMISE ID #
0012986000002MedicaidPA
390002631OtherPATRVP #

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110103000202 PA Practitioner - Nephrology 3173588118 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bryn Mawr Nephrology Assoc. LTD Specialist CurrentSince Sep 11, 1979 Accepting new patients
Bryn Mawr Medical Specialists Association Specialist Past Accepting new patients

Locations

830 Old Lancaster Rd
Ste 206
Bryn Mawr, PA 19010
Phone (610) 525-8110

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1942223573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 OLD LANCASTER RD",
            "address_2": "SUITE 206",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103118",
            "telephone_number": "610-525-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 OLD LANCASTER RD",
            "address_2": "SUITE 206",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103118",
            "telephone_number": "610-525-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOSKEY",
        "first_name": "GREGORY",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD038267L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "098735",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROMISE ID #",
            "identifier": "0012981000002",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012986000002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRVP #",
            "identifier": "390002631",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.