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DR. LUIS LEDESMA GAMBOA M.D.
NPI 1699936062
Emergency Medicine - Pediatric Emergency Medicine in Philadelphia, PA

Active since June 18, 2008PECOS Enrolled
3401 N BROAD ST, PHILADELPHIA, PA 19140(215) 707-5030(215) 707-3494 Get Directions Write a Review

NPPES record last updated: April 24, 2018. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Luis Ledesma Gamboa M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. LUIS LEDESMA GAMBOA M.D. (NPI 1699936062) is an individual pediatric emergency medicine provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD450133) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1699936062
Entity TypeIndividualMale
Primary Taxonomy207PP0204X
Provider Legal NameDR. LUIS LEDESMA GAMBOACredential: M.D.
Location Address3401 N BROAD STPhiladelphia, PA 19140-5103
Mailing Address2450 W Hunting Park AvePhiladelphia, PA 19129-1302 · (215) 707-5030 · Fax (215) 707-3494
Phone(215) 707-5030
Fax(215) 707-3494
Sole ProprietorYes
Enumeration DateJune 18, 2008
Last NPPES UpdateApril 24, 2018
✔ NPI 1699936062 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency Medicine · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207PP0204X
License✔ Licensed in PA · MD450133
Definition
Pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department.
3401 N BROAD ST, Philadelphia, PA 19140
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Luis Ledesma Gamboa M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Luis Gamboa reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Stc Pediatrics LLC
1.3 mi
Pediatrics
3645 N FRONT ST
Philadelphia, PA 19134
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 479 clinicians in this Medicare group
NPI 1346884574 (215) 427-5000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19140 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$92.69 typical visit price
range $59.88 – $180.99
Typical copayment $23.17 (range $14.97 – $45.24)
Most-billed visit code 99203
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JAMIE L. GARFIELD MD
Internal Medicine
3401 N BROAD ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 707-5864
ELIZABETH DIANE DAUER MD
Surgery
3401 N BROAD ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 707-3133
MARIA ESTHER ESCORCIA DE LEON M.D.
Internal Medicine
3401 N BROAD ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 707-1622
JEONGAE YOON M.D.
Anesthesiology
3401 N BROAD ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 707-3326
DR. SUSETE CARNEIRO M.D.
Surgery
3401 N BROAD ST
PHILADELPHIA, PA 19140
Philadelphia County (201) 317-3485
DR. SARAH DENISE FENERTY M.D.
Radiology (Diagnostic Radiology)
3401 N BROAD ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 707-7237
TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Radiology (Radiation Oncology)
3401 N BROAD ST
PHILADELPHIA, PA 19140
Philadelphia County (215) 707-4233
EDUARDO DOMINGUEZ CASTILLO M.D.
Internal Medicine (Pulmonary Disease)
3401 N BROAD ST, 812 PARKINSON PAVILION
PHILADELPHIA, PA 19140
Philadelphia County (215) 707-5864

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Luis Gamboa's NPI number?

The NPI number for Luis Gamboa is 1699936062. It was assigned to this individual provider in the NPPES registry on June 18, 2008.

Where is Luis Gamboa located?

Luis Gamboa practices at 3401 N Broad St, Philadelphia, PA 19140. The listed phone number is (215) 707-5030.

What is Luis Gamboa's specialty?

The primary specialty registered for this NPI is Emergency Medicine, specializing in Pediatric Emergency Medicine, with taxonomy code 207PP0204X.

Is Luis Gamboa enrolled in Medicare?

Yes. Luis Gamboa is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Luis Gamboa's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Luis Gamboa reassigns Medicare benefits to Stc Pediatrics LLC (Philadelphia, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Luis Gamboa's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Luis Gamboa accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Luis Gamboa as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Luis Gamboa was last updated on April 24, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.