Dr Jonathan Gusdorff, DO is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Havertown, Pennsylvania. His current practice location is
1305 W Chester Pike, Havertown, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at
(610) 482-4949.
Dr Jonathan Gusdorff is licensed to practice in Pennsylvania (license number OS010370L) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1891792255.
Physician's Profile
| Full Name | Dr Jonathan Gusdorff |
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| Gender | Male |
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| Speciality | Radiology - Diagnostic Radiology |
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| Location | 1305 W Chester Pike, Havertown, Pennsylvania |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1891792255
- Provider Enumeration Date: 06/30/2005
- Last Update Date: 11/21/2019
Medicare PECOS Information:
- PECOS PAC ID: 0446235832
- Enrollment ID: I20110505000588
Medical Identifiers
Medical identifiers for Dr Jonathan Gusdorff such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1891792255 | NPI | - | NPPES |
| 200114580A | Medicaid | OK | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2085N0700X | Radiology - Neuroradiology | 02005865A (Indiana) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | 4519 (Oklahoma) | Secondary |
| 174400000X | Specialist | OS010370L (Pennsylvania) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | OS010370L (Pennsylvania) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jonathan Gusdorff allows following entities to bill medicare on his behalf.
| Entity Name | Sutter Valley Medical Foundation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1669846986
PECOS PAC ID: 9830094515
Enrollment ID: O20090311000335 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jonathan Gusdorff is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Jonathan Gusdorff, DO
1305 W Chester Pike,
Havertown, PA 19083-2929
Ph: (610) 482-4949 | Dr Jonathan Gusdorff, DO
1305 W Chester Pike,
Havertown, PA 19083-2929
Ph: (610) 482-4949 |
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