Individual provider Active NPI

Robert J Gary, M.D.

  • Urology Physician
  • Media, PA
National Provider Identifier
1972563427
Registry record updated May 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD036095E Issued in PA
Practice address
200 State Street
Suite 205
Media, PA 19063-3434
Phone
(610) 521-4112
Fax
(610) 521-6864
NPI assigned
Mar 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X
Urology Physician 208800000X MD036095E PA Primary

Addresses

Primary practice location

200 State Street
Suite 205
Media, PA 19063-3434

Mailing address

PO Box 37864
Baltimore, MD 21297-7864
Phone (610) 382-5916

Other practice location 1

100 Maris Grove Way
Glen Mills, PA 19342-1282
Phone (610) 565-2776

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
I20070917000235 PA Practitioner - Urology 7719071133 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physician Services, PC / Dba Midlantic Urology Urology CurrentSince Apr 20, 2017 Accepting new patients
Alliance Physician Services, PC Urology Current Accepting new patients
Alliance Physician Services, PC Urology CurrentSince Apr 20, 2017 Accepting new patients

Locations

919 Conestoga Rd
Bldg 1
Bryn Mawr, PA 19010
Phone (610) 525-6400

1 Medical Center Blvd
Ste 105
Chester, PA 19013
Phone (610) 874-4870

100 Maris Grove Way
Glen Mills, PA 19342
Phone (610) 387-4520

500 Evergreen Dr
Ste G5
Glen Mills, PA 19342
Phone (610) 566-4383

211 S Gulph Rd
Ste 200
Kng of Prussa, PA 19406
Phone (610) 382-5910

200 E State St
Ste 205
Media, PA 19063
Phone (610) 521-4112

200 E State St
Media, PA 19063
Phone (610) 565-2776

Organizations & group practices 3

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": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1972563427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37864",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212977864",
            "telephone_number": "610-382-5916",
            "fax_number": "484-381-8028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 STATE STREET",
            "address_2": "SUITE 205",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633434",
            "telephone_number": "610-521-4112",
            "fax_number": "610-521-6864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Maris Grove Way",
            "address_purpose": "LOCATION",
            "city": "Glen Mills",
            "state": "PA",
            "postal_code": "193421282",
            "country_code": "US",
            "telephone_number": "610-565-2776",
            "fax_number": "610-565-4247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARY",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MD036095E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.