Individual provider Active NPI

Phillip Gvozden, MD

  • Family Medicine Physician
  • Johnstown, PA
National Provider Identifier
1992709497
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD069402L Issued in PA
Practice address
128 Fairfield Ave
Johnstown, PA 15906-2331
Phone
(814) 809-7130
Fax
(814) 809-7131
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD069402L PA Primary

Addresses

Primary practice location

128 Fairfield Ave
Johnstown, PA 15906-2331

Mailing address

128 Fairfield Ave
Johnstown, PA 15906-2331
Phone (814) 809-7130

Other identifiers 1

IdentifierTypeStateIssuer
0017589700005MedicaidPA

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
I20100512000034 PA Practitioner - Family Practice 1850429986 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vantage Physical Therapy and Rehabilitation IncGroup PAC ID 3072424886, 253 clinicians

Practice addresses (Care Compare)

128 Fairfield Ave
Johnstown, PA 15906-2331
Phone (814) 809-7130

336 Bloomfield St
Johnstown, PA 15904-3271
Phone (814) 269-2224

Hospital & facility affiliations

  • Conemaugh Home Health Home health agency, Johnstown, PA, CCN 397406
  • Conemaugh Memorial Medical Center Hospital, Johnstown, PA, CCN 390110
  • Chan Soon- Shiong Medical Center at Windber Hospital, Windber, PA, CCN 390112

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Conemaugh Physician Practices LLC Family Medicine CurrentSince Sep 1, 2014 Accepting new patients
DLP Conemaugh Physician Practices LLC Family Medicine CurrentSince Sep 1, 2014 Accepting new patients
DLP Conemaugh Physician Practices LLC Family Medicine Current Accepting new patients
Gvozden Integrated Health PC Family Medicine CurrentSince Aug 1, 2024 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

236 Jamesway Rd
Ebensburg, PA 15931
Phone (814) 471-6595

128 Fairfield Ave
Johnstown, PA 15906
Phone (814) 535-1621

1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

1 Tech Park Dr
Johnstown, PA 15901
Phone (814) 475-8600

1020 Franklin St
Johnstown, PA 15905
Phone (814) 533-1095

Interoperability endpoints

  • Direct secure messaging: drgvozden@chp.medentdirect.com

Organizations & group practices 6

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": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1992709497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 FAIRFIELD AVE",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159062331",
            "telephone_number": "814-809-7130",
            "fax_number": "814-809-7131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 FAIRFIELD AVE",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159062331",
            "telephone_number": "814-809-7130",
            "fax_number": "814-809-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GVOZDEN",
        "first_name": "PHILLIP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD069402L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017589700005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.