Active NPI 1376774570 Individual Practitioner Male Practitioner

Dr. Gopal Atmaram Patel , MD

Dermatology • Media, PA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Gopal Patel, MD is a certified Dermatology practicing in Media, PA. With approximately 17 years of clinical experience since graduating from Rutgers New Jersey Medical School in 2009, Dr. Patel delivers high-quality medical care to the local community at 176 S NEW MIDDLETOWN RD STE 203.

Dr. Patel is affiliated with Aesthetic Dermatology Associates Pc and accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

176 S New Middletown Rd Ste 203

Media, PA 19063

Telephone 6105667300

Fax 6105668973

Associated Practice Facility / Clinic

🏢 Aesthetic Dermatology Associates, Pc Facility NPI 1003845835

Medicare Profile & Education

Medical School

Rutgers New Jersey Medical School

Graduation Year

2009

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Media, PA

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

17 Yrs -2.8 yrs vs City Avg

City Avg: 19.8 Yrs

State Avg: 22.2 Yrs

Regional Practice Density

14 Specialists

Practicing in Media, PA (694 Statewide)

Telehealth Adoption Rate

7.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

50.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Patel (17 Years) 17 Yrs

Media Specialty Average (19.8 Years) 19.8 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,527	334	$30.00	$6.77
99213 Established patient office or other outpatient visit, typically 15 minutes	875	676	$150.00	$93.23
17000 Destruction of skin growth	639	467	$130.00	$56.72
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	411	320	$200.00	$130.48
11102 Tangential biopsy of single skin lesion	303	267	$190.00	$94.29
17110 Destruction of up to 14 skin growths	260	214	$200.00	$116.23
11103 Biopsy of related skin growth, each additional growth	69	46	$85.00	$48.73
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	66	59	$100.00	$58.18
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	62	46	$300.00	$162.13
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	55	55	$225.00	$113.02
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	42	40	$505.00	$302.26
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	41	41	$225.00	$171.85
15789 Chemical peel of skin of face	38	36	$1000.00	$551.30
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	33	16	$2.00	$1.01
11200 Removal of skin tag, 1-15 skin tags	31	30	$160.00	$80.26
11104 Punch biopsy, first skin growth	26	25	$210.00	$128.98
11900 Injection into skin growth, 1-7 growths	24	15	$115.00	$52.02
15793 Chemical peel of deep layer of nonfacial skin	24	24	$1000.00	$287.50
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	22	22	$465.00	$143.84
99202 New patient office or other outpatient visit, typically 20 minutes	21	21	$125.00	$74.33
17004 Destruction of precancer skin growth, 15 or more growths	14	12	$250.00	$160.54

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,055	420	$30.00	$7.06
99213 Established patient office or other outpatient visit, typically 15 minutes	1,003	810	$150.00	$94.02
17000 Destruction of skin growth	741	575	$130.00	$55.86
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	398	346	$200.00	$131.82
11102 Tangential biopsy of single skin lesion	355	306	$190.00	$97.12
17110 Destruction of up to 14 skin growths	287	255	$200.00	$117.47
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	82	80	$100.00	$59.25
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	80	61	$300.00	$166.26
11103 Biopsy of related skin growth, each additional growth	77	56	$85.00	$53.37
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	48	48	$202.08	$117.33
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	46	46	$225.00	$173.13
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	40	39	$505.00	$314.92
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	36	24	$2.00	$1.07
11900 Injection into skin growth, 1-7 growths	30	22	$115.00	$53.45
11200 Removal of skin tag, 1-15 skin tags	28	25	$160.00	$76.08
17004 Destruction of precancer skin growth, 15 or more growths	28	24	$250.00	$179.35
15789 Chemical peel of skin of face	24	22	$1000.00	$562.36
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	22	22	$465.00	$147.74
99202 New patient office or other outpatient visit, typically 20 minutes	21	21	$125.00	$76.08
11104 Punch biopsy, first skin growth	17	17	$210.00	$129.87
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	16	14	$200.00	$119.72
69100 Biopsy of ear	15	15	$170.00	$75.39
17111 Destruction of skin growth, 15 or more growths	14	12	$225.00	$140.68
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	12	12	$230.00	$143.71
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	11	11	$415.00	$129.49
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	11	11	$310.00	$204.20
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	11	11	$165.00	$98.42

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,155	433	$30.00	$7.43
99213 Established patient office or other outpatient visit, typically 15 minutes	1,012	810	$150.00	$97.32
17000 Destruction of skin growth	765	589	$130.00	$59.96
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	425	366	$199.88	$137.10
11102 Tangential biopsy of single skin lesion	374	328	$190.00	$103.56
17110 Destruction of up to 14 skin growths	278	244	$180.49	$123.60
96910 Skin application of tar and ultraviolet B or petrolatum and ultraviolet B	142	11	$204.40	$131.50
11103 Biopsy of related skin growth, each additional growth	124	76	$85.00	$56.53
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	90	88	$100.00	$61.15
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	79	62	$300.00	$169.07
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	76	76	$200.00	$120.85
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	55	30	$2.00	$1.14
11900 Injection into skin growth, 1-7 growths	51	29	$115.00	$54.91
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	50	50	$225.00	$179.42
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	40	39	$505.00	$321.78
17004 Destruction of precancer skin growth, 15 or more growths	35	30	$250.00	$185.67
11104 Punch biopsy, first skin growth	32	32	$210.00	$140.66
11200 Removal of skin tag, 1-15 skin tags	32	31	$160.00	$77.21
99202 New patient office or other outpatient visit, typically 20 minutes	31	31	$125.00	$78.84
15789 Chemical peel of skin of face	26	26	$1000.00	$580.99
69100 Biopsy of ear	25	25	$170.00	$83.43
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	21	18	$310.00	$197.32
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	21	20	$465.00	$152.81
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	15	15	$415.00	$133.95
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	12	12	$230.00	$142.35

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,154	346	$30.00	$7.16
99213 Established patient office or other outpatient visit, typically 15 minutes	857	678	$146.28	$98.26
17000 Destruction of skin growth	658	466	$130.00	$57.88
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	448	349	$192.50	$138.86
11102 Tangential biopsy of single skin lesion	310	273	$190.00	$106.41
17110 Destruction of up to 14 skin growths	269	221	$180.20	$123.22
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	97	93	$97.11	$60.69
11103 Biopsy of related skin growth, each additional growth	72	49	$85.00	$58.62
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	70	70	$195.71	$120.06
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	59	46	$300.00	$178.99
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	55	51	$505.00	$332.71
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	55	55	$225.00	$181.37
17004 Destruction of precancer skin growth, 15 or more growths	54	36	$250.00	$180.96
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	44	25	$2.00	$1.29
11200 Removal of skin tag, 1-15 skin tags	39	37	$160.00	$74.93
11900 Injection into skin growth, 1-7 growths	36	23	$115.00	$54.33
11104 Punch biopsy, first skin growth	34	33	$210.00	$140.36
99202 New patient office or other outpatient visit, typically 20 minutes	34	34	$125.00	$79.19
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	32	30	$465.00	$160.40
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	16	16	$495.00	$344.95
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	14	14	$415.00	$146.85
69100 Biopsy of ear	13	11	$170.00	$84.49
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	12	11	$200.00	$126.69

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,893	336	$30.00	$6.55
17000 Destruction of skin growth	603	458	$130.00	$56.59
99213 Established patient office or other outpatient visit, typically 15 minutes	595	483	$95.00	$81.37
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	594	499	$140.00	$117.34
17110 Destruction of up to 14 skin growths	298	237	$186.58	$121.52
96910 Skin application of tar and ultraviolet B or petrolatum and ultraviolet B	250	11	$150.00	$129.00
11102 Tangential biopsy of single skin lesion	236	216	$179.32	$100.60
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	170	161	$65.00	$49.64
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	69	52	$286.96	$169.86
11103 Biopsy of related skin growth, each additional growth	62	46	$73.87	$58.02
11200 Removal of skin tag, 1-15 skin tags	47	42	$147.66	$73.02
99202 New patient office or other outpatient visit, typically 20 minutes	44	44	$100.00	$82.24
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	41	40	$498.90	$327.10
17004 Destruction of precancer skin growth, 15 or more growths	37	31	$250.00	$174.46
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	37	37	$150.00	$115.04
11104 Punch biopsy, first skin growth	31	30	$185.16	$139.10
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	28	22	$2.00	$1.44
11900 Injection into skin growth, 1-7 growths	28	22	$102.86	$54.13
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	26	25	$456.35	$155.94
99201 New patient office or other outpatient visit, typically 10 minutes	20	20	$80.00	$50.16
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	11	11	$168.18	$127.64

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,933	324	$30.00	$6.21
99213 Established patient office or other outpatient visit, typically 15 minutes	669	503	$95.00	$79.16
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	667	545	$140.00	$116.24
17000 Destruction of skin growth	657	444	$130.00	$57.71
11102 Tangential biopsy of single skin lesion	298	259	$175.00	$95.59
17110 Destruction of up to 14 skin growths	287	242	$175.00	$118.05
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	267	246	$65.00	$48.54
96910 Skin application of tar and ultraviolet B or petrolatum and ultraviolet B	227	12	$147.14	$123.89
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	89	89	$150.00	$114.73
99202 New patient office or other outpatient visit, typically 20 minutes	79	79	$100.00	$81.47
11104 Punch biopsy, first skin growth	53	52	$175.00	$133.04
11103 Biopsy of related skin growth, each additional growth	52	45	$70.00	$58.15
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	52	32	$2.00	$1.59
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	51	46	$495.00	$326.99
11200 Removal of skin tag, 1-15 skin tags	46	43	$140.00	$75.54
11900 Injection into skin growth, 1-7 growths	40	25	$95.00	$56.32
99201 New patient office or other outpatient visit, typically 10 minutes	37	37	$80.00	$49.49
17004 Destruction of precancer skin growth, 15 or more growths	27	21	$250.00	$166.03
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	25	20	$280.00	$181.38
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	24	23	$400.00	$136.08
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	20	19	$450.00	$155.56
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	15	15	$230.00	$147.80
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	11	11	$150.00	$130.95
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	11	11	$470.00	$250.43

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,036	329	$30.00	$5.67
17000 Destruction of skin growth	680	445	$130.00	$57.48
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	641	520	$140.00	$113.88
99213 Established patient office or other outpatient visit, typically 15 minutes	621	478	$95.00	$77.27
11100 Biopsy of single growth of skin and/or tissue	385	324	$175.00	$103.03
17110 Destruction of up to 14 skin growths	285	231	$175.00	$118.21
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	242	223	$65.00	$46.78
99202 New patient office or other outpatient visit, typically 20 minutes	110	110	$100.00	$79.96
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	78	78	$150.00	$115.45
11101 Biopsy of each additional growth of skin and/or tissue	64	51	$70.00	$35.29
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	62	36	$2.00	$1.79
11900 Injection into skin growth, 1-7 growths	57	34	$95.00	$57.06
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	48	46	$495.00	$323.51
17004 Destruction of precancer skin growth, 15 or more growths	45	33	$250.00	$155.94
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	39	36	$280.00	$177.63
11200 Removal of skin tag, 1-15 skin tags	37	36	$140.00	$74.56
99201 New patient office or other outpatient visit, typically 10 minutes	27	27	$80.00	$47.71
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	23	21	$400.00	$140.21
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	20	20	$450.00	$154.05
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	12	12	$265.00	$90.46
11401 Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm	11	11	$235.00	$140.03
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	11	11	$150.00	$123.85

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,243	354	$30.00	$5.90
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	692	554	$140.00	$109.51
17000 Destruction of skin growth	686	472	$130.00	$54.35
99213 Established patient office or other outpatient visit, typically 15 minutes	550	447	$95.00	$74.56
11100 Biopsy of single growth of skin and/or tissue	411	351	$175.00	$99.75
17110 Destruction of up to 14 skin growths	285	227	$175.00	$113.32
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	274	242	$65.00	$44.76
99202 New patient office or other outpatient visit, typically 20 minutes	117	117	$100.00	$76.60
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	108	108	$150.00	$111.45
11101 Biopsy of each additional growth of skin and/or tissue	91	69	$70.00	$33.64
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	63	30	$2.00	$1.81
11900 Injection into skin growth, 1-7 growths	56	29	$95.00	$49.01
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	51	46	$495.00	$305.99
17004 Destruction of precancer skin growth, 15 or more growths	50	37	$250.00	$155.65
11200 Removal of skin tag, 1-15 skin tags	47	42	$140.00	$76.14
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	40	33	$280.00	$167.81
99201 New patient office or other outpatient visit, typically 10 minutes	31	31	$80.00	$45.33
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	22	20	$230.00	$128.73
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	21	21	$400.00	$147.31
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	16	16	$450.00	$147.34
69100 Biopsy of ear	12	11	$170.00	$92.05

Medical Specialties & State Licenses

CMS Verified: 2023-12-19

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License PA MD448297

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Hospital & Practice Group Affiliations

Aesthetic Dermatology Associates Pc

176 S New Middletown Rd, Media, PA 190635255

Phone: 6105667300

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners

Dr. Clare Goggins , MD

Dermatology

NPI 1043770183

Doctor of Medicine (M.D.)

Dr. Amy Basile , DO, MPH

Dermatology

NPI 1487897617

Doctor of Osteopathic Medicine (D.O.), Master of Public Health

Dr. Valerie Hanft , MD

Dermatology

NPI 1528030392

Doctor of Medicine (M.D.)

Laura Schilling

Dermatology

NPI 1740523315

Dr. Catherine Waller , MD

Dermatology

NPI 1750030375

Doctor of Medicine (M.D.)

Nancy Conley , PA-C

Physician Assistant

NPI 1790113587

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Practice Location May 24, 2018

Registered at 176 S NEW MIDDLETOWN RD STE 203, MEDIA, PA 19063 (Tel: 6105667300)

📍

Updated Business Mailing Address May 24, 2018

Registered at 176 S NEW MIDDLETOWN RD STE 203, MEDIA, PA 190635255 (Tel: 6105667300)

✅

NPI Profile Active July 17, 2013

NPI status registered as active in NPPES database

📍

Updated Practice Location July 17, 2013

Registered at 1088 W BALTIMORE PIKE, SUITE 2506, MEDIA, PA 190635146 (Tel: 6105667300)

📍

Updated Business Mailing Address July 17, 2013

Registered at 1088 W BALTIMORE PIKE, SUITE 2506, MEDIA, PA 190635146 (Tel: 6105667300)

👤

Provider Name / Credentials Updated July 17, 2013

Recorded as GOPAL PATEL, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 17, 2013

Dermatology (License #MD448297 in PA)

🟢

Initial NPI Registration & Enumeration August 05, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1376774570

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 05, 2009

Last Update: December 19, 2023

Sole Proprietor: No

Update or Correct Profile

Mailing Address

176 S New Middletown Rd Ste 203

Media, PA 190635255

Phone: 6105667300

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

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This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.