Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Surya K Vangore, MDPC

Individual provider Family Medicine Physician · NPI 1043279524

Dr. Surya K Vangore, MDPC is a Family Practice in Philadelphia, Pennsylvania. Qualified in 1972, 54 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
54
Licensed in
PA
In the registry since
2006
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Practice location Address checks out

431 W Roosevelt Blvd
Philadelphia, PA 19120-4148
Phone: (215) 455-3444
Fax: (215) 455-3445
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence MD038910L (PA)

Record details

NPI number1043279524
Entity typeIndividual (Type 1)
GenderFemale
Credentials MDPC
Sole proprietorYes
NPI enumeratedMarch 22, 2006
Last updated in NPPESJanuary 10, 2025
Certification dateJanuary 10, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 1972 (54 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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