George Anthony Ptakowski, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD040378-L Issued in PA

Practice address

PO Box 147
Pocono Lake, PA 18347-0147

Phone

(570) 646-6905

Fax

(570) 646-6009

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Mt. Pocono Family Practice Center

  • Family Medicine Physician
  • Pocono Lake, PA
  • NPI 1194803825
  NPD (past) Authorized official

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1013027861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 AUDUBON DRIVE",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "18411",
            "telephone_number": "570-576-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 147",
            "city": "POCONO LAKE",
            "state": "PA",
            "postal_code": "183470147",
            "telephone_number": "570-646-6905",
            "fax_number": "570-646-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PTAKOWSKI",
        "first_name": "GEORGE",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD040378-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01158190",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colleen Anne Donahue, BCBA
• Blanche Howard, B.A., C.C.H.
• Christina Lascala, LPN
• Christine Lauff
• Mt. Pocono Family Practice Center
• James A. Rinehimer, D.D.S.
• Maureen Ann Rinehimer, PT MHS
• Unbound and Grounded Counseling Inc

• Family Medicine Physician in Pocono Lake, PA
• Providers in Pocono Lake, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.