SUBBARAO GORTI (NPI# 1356399075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356399075 |
| Entity Type | Individual |
| Full Name | SUBBARAO GORTI |
| Credential | M.D. |
| Practice Address |
1139 E Luzerne St Philadelphia PA 19124-5234 |
| Mailing Address |
P. O. Box 8500 - 6335 Philadelphia PA 19178-0001 |
| Practice Telephone | 2155375094 |
| Practice Fax Number | 2155375096 |
| Mailing Telephone | 2158078000 |
| Mailing Fax Number | 2155375096 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2019-04-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD048575L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0013058950002 | 05 | |
| PA | AETNA | 118031 | 01 |
| PA | HIGHMARK BLUE SHIELD | 186650 | 01 |
| PA | UNITED HEALTHCARE | 1024550 | 01 |
| PA | CLEAR CARE | 8696 | 01 |
| PA | 0013058950006 | 05 | |
| PA | AMERICHOICE | 01305895-02 | 01 |
| PA | TRICARE | PA0049853 | 01 |
| PA | CIGNA | 3832822 | 01 |
| PA | PHCS | 810159612 | 01 |
| PA | 0013058920001 | 05 | |
| PA | IBC,KEYSTONE | 0279193000 | 01 |
| PA | RAILROAD MEDICARE | 080105711 | 01 |
| PA | KEYSTONE MERCY | 1022053 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 412 W Lehigh Ave, Philadelphia, PA 191333148 | 2677652272 |
| Street Address |
1139 E LUZERNE ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19124-5234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225664436 | Jonathan David Picker | Social Worker | 1139 E Luzerne St, Philadelphia, PA 19124-5234 | 2020-03-19 |
| 1639518327 | Jessy Edgardo Ang Jr. | Family Medicine | 1139 E Luzerne St, Philadelphia, PA 19124 | 2013-06-17 |
| 1508991589 | Aria Health Physician Services - Juniata | Family Medicine | 1139 E Luzerne St, Philadelphia, PA 19124-5234 | 2007-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831749308 | William Mark Hanna Sr. | Pharmacist | 4600 Rooselvelt Blvd Bldg G, Philadelphia, PA 19124 | 2019-09-17 |
| 1881256451 | Medical Discovery Systems, LLC | Durable Medical Equipment & Medical Supplies | 5425 Oxford Ave., 5425 Oxford Ave. Suite (3 A), Philadelphia, PA 19124 | 2019-07-03 |
| 1548731391 | Sierra Pinkney | Registered Nurse | 1615 Granite St, Philadelphia, PA 19124 | 2018-12-05 |
| 1922507987 | Xavier Sergio Henriquez | Counselor | 4510 Frankford Avenue 2nd Floor, Philadelphia, PA 19124 | 2018-02-06 |
| 1558881581 | Isabel Cristina Castillo Hernandez | Pediatrics | 4500-10, Apt 201b, Philadelphia, PA 19124 | 2017-06-21 |
| 1952843732 | Patrick Grugan | Social Worker | Roosevelt Boulevard & Adams Avenue, Philadelphia, PA 19124 | 2016-11-10 |
| 1811340482 | Katarzyna Liwski | Psychiatry & Neurology | 4641 Roosevelt Boulevard, E212, Drexel University College of Medicine Friends Hospital, Philadelphia, PA 19124 | 2016-07-19 |
| 1851769327 | Aleka Kostouros | Social Worker | Roosevelt Blvd & Adams Ave, Northeast Community Center for Behavioral Health, Philadelphia, PA 19124 | 2015-09-14 |
| 1407230378 | Sara Bachani | Psychiatry & Neurology | 4641 Roosevelt Blvd, Friends Hospital, Room 231, Philadelphia, PA 19124 | 2015-07-10 |
| 1215327051 | Alyssa Renee Kirk | Counselor | 4500-10 Frankford Ave, 2nd Floor, Philadelphia, PA 19124 | 2015-02-02 |
| Find all providers in zip 19124 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619587227 | Cmp Medical LLC | Family Medicine | 3626 Sears St, Philadelphia, PA 19146-3217 | 2020-08-07 |
| 1225648140 | Action Health Centers Inc | Family Medicine | 1006 W Lehigh Ave Ste 200, Philadelphia, PA 19133-1640 | 2020-08-05 |
| 1285289876 | Visiting Doctors Inc | Family Medicine | 2338 S Broad St Ste 1, Philadelphia, PA 19145-4450 | 2019-08-09 |
| 1770137218 | Health Care At Northeast Philadelphia LLC | Family Medicine | 3353 Cottman Avenue, Philadelphia, PA 19149-1603 | 2019-08-01 |
| 1679131585 | Aria Health Physician Services | Family Medicine | 3998 Red Lion Rd Ste 204, Philadelphia, PA 19114-1440 | 2019-06-05 |
| 1689232597 | Aria Health Physician Services | Family Medicine | 5000 Frankford Ave Ste 1, Philadelphia, PA 19124-2620 | 2019-06-05 |
| 1174096432 | Temple University of The Commonwealth System of Higher Education | Family Medicine | 2300 W Master St Ste 109b, Philadelphia, PA 19121-4739 | 2019-01-09 |
| 1679043152 | Prevention Point Philadelphia | Family Medicine | 2913-15 Kensington Ave, Philadelphia, PA 19134-3016 | 2018-11-28 |
| 1700362266 | Wes Corporation | Family Medicine | 5000 N 13th St, Philadelphia, PA 19141-3533 | 2018-07-17 |
| 1376046508 | Philly Medical and Rehab Associates | Family Medicine | 6401 Rising Sun Ave, Philadelphia, PA 19111-5228 | 2018-03-14 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19124 |
Please comment or provide details below to improve the information on SUBBARAO GORTI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.