Active NPI
Suresh Chandra Ghosh, MD
- Vascular Surgery Physician
- Philadelphia, PA
National Provider Identifier
1962424390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- MD032109L
- Practice address
- 5000 Frankford Ave
Wakeling Building
Philadelphia, PA 19124-2620 - Phone
- (215) 831-2355
- Fax
- (215) 831-2017
- NPI assigned
- Jul 24, 2006
- Last updated
- Oct 20, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | MD032109L | PA | Primary |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | MD032109L | PA |
Addresses
Primary practice location
5000 Frankford Ave
Wakeling Building
Philadelphia, PA 19124-2620
Mailing address
PO Box 8500-6335
Philadelphia, PA 19178-6335
Phone (215) 807-8000
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0008205440005 | Medicaid | PA | |
| 30065497 | Other | PA | KEYSTONE MERCY |
| 6974266 | Other | PA | AETNA HMO |
| 5574330 | Other | PA | AETNA PPO |
| 0052523000 | Other | PA | INDEPENDENCE BLUE CROSS |
| 037241 | Other | PA | HIGHMARK BLUE SHIELD |
| 30685MD032109L | Other | PA | HEALTH PARTNERS |
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 |
|---|---|---|---|
| MD032109L | PA | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aria Health Physician Services | Past | Accepting new patients | |
| Temple Physician Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Geoffrey W. Temple Family Medical Associates
- Family Medicine Physician
- Philadelphia, PA
- NPI 1053181297
-
- Internal Medicine Physician
- Feasterville Trevose, PA
- NPI 1174497366
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319068800000",
"number": "1962424390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8500-6335",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191786335",
"telephone_number": "215-807-8000",
"fax_number": "215-831-2017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000 FRANKFORD AVE",
"address_2": "WAKELING BUILDING",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191242620",
"telephone_number": "215-831-2355",
"fax_number": "215-831-2017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHOSH",
"first_name": "SURESH",
"middle_name": "CHANDRA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2011-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "PA",
"license": "MD032109L",
"primary": true
},
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "PA",
"license": "MD032109L",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0008205440005",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE MERCY",
"identifier": "30065497",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "6974266",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "5574330",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENCE BLUE CROSS",
"identifier": "0052523000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "037241",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "30685MD032109L",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.