WILLIAM J GAUGHAN (MD) – Nephrology Physician, NPI 1255390035

WILLIAM J GAUGHAN (MD) is a healthcare provider. based in Philadelphia, Pennsylvania. specializing in Nephrology Physician. They hold the professional credentials MD. They hold a License No. MD031609E (PA). The NPI Number for WILLIAM J GAUGHAN (MD) is 1255390035

Main info

Male
43 Years Of Experience
Accepts Medicare Assignment
Name
WILLIAM J GAUGHAN (MD)
NPI
1255390035
Phone
(215) 456-7000
Address
101 EAST OLNEY AVENUE
Enumeration Date
21 March 2006
Last Update Date
6 January 2011

Doctor Profile

Medical School Name
HAHNEMANN UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
2156572012
Graduation Year
1983 (43 years ago)
PAC ID
0840241881
Group Practice PAC ID
6103809967
Professional Enrollment ID
I20050207000729
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for WILLIAM J GAUGHAN (MD)

  • Burger King, 101, East Olney Avenue, Olney, Philadelphia, Philadelphia County, Pennsylvania, 19120, United States

    SUITE 400

    PHILADELPHIA, PA 19120

    Phone: (215) 456-7000

    Fax: (215) 254-2599

    Type: Mailing

  • Einstein Medical Center Philadelphia, 5501, Old York Road, Tabor, Philadelphia, Philadelphia County, Pennsylvania, 19141, United States

    LEVY GRD FLOOR

    PHILADELPHIA, PA 19141

    Phone: (215) 456-6970

    Fax: (215) 456-7154

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-02-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050207000729INephrologyPATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 19120)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6103809967View full group profile
NameSpecialtyState
Nephrology, Internal MedicinePA
Nephrology, Internal MedicinePA
Nurse PractitionerPA
Nephrology, Neurology, Endocrinology, Internal MedicinePA
-PA
Nephrology, Internal MedicinePA
Internal Medicine, Family Practice, NephrologyPA
-PA
Nephrology, Internal MedicinePA
Nurse PractitionerPA

Reviews

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Frequently asked questions

Where can patients find WILLIAM J GAUGHAN (MD)'s NPI?
You can confirm WILLIAM J GAUGHAN (MD) with NPI 1255390035; it appears in the national provider directory.
Is WILLIAM J GAUGHAN (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does WILLIAM J GAUGHAN (MD) list a primary specialty?
If you are matching referrals, note Nephrology Physician for WILLIAM J GAUGHAN (MD). Clinical services aligned with this taxonomy classification.
Does WILLIAM J GAUGHAN (MD) practice in Pennsylvania?
You will see Philadelphia, Pennsylvania on file for WILLIAM J GAUGHAN (MD) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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