Individual provider Active NPI

Stephen Anthony Olenchock Jr., D.O.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Fountain Hill, PA
National Provider Identifier
1003866781
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
223128 Issued in MA
Practice address
701 Ostrum St
Suite 201
Fountain Hill, PA 18015-1155
Phone
(610) 954-3890
Fax
(610) 868-2915
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 223128 MA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 223128 MA Primary

Addresses

Primary practice location

701 Ostrum St
Suite 201
Fountain Hill, PA 18015-1155

Mailing address

701 Ostrum St
Suite 201
Fountain Hill, PA 18015-1155
Phone (484) 526-3890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080616000670 PA Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 0446254254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
223128MAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Physician Group, Inc. Current Accepting new patients
St Luke's Physician Group Inc CurrentSince Jul 1, 2008 Accepting new patients
St. Luke's Physician Group, Inc. Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Jul 1, 2008 Accepting new patients
Caritas Medical Group, Inc. Past Accepting new patients

Locations

701 Ostrum St
Ste 603
Fountain Hill, PA 18015
Phone (484) 526-3990

701 Ostrum St
Ste 201
Fountain Hill, PA 18015
Phone (610) 868-1014

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364774400000",
    "number": "1003866781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 OSTRUM ST",
            "address_2": "SUITE 201",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180151155",
            "telephone_number": "484-526-3890",
            "fax_number": "610-868-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 OSTRUM ST",
            "address_2": "SUITE 201",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180151155",
            "telephone_number": "610-954-3890",
            "fax_number": "610-868-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLENCHOCK",
        "first_name": "STEPHEN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2013-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MA",
            "license": "223128",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MA",
            "license": "223128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Hill, PA

Sources for this page

Verify at the official NPI Registry.