Individual provider Active NPI

Stephen F Wawrose, MD

  • Otolaryngology Physician
  • Bethel Park, PA
National Provider Identifier
1013942564
Registry record updated Mar 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD058860L Issued in PA
Practice address
2000 Oxford Dr
Suite 201
Bethel Park, PA 15102-1841
Phone
(412) 831-7570
Fax
(412) 854-6149
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD058860L PA Primary

Addresses

Primary practice location

2000 Oxford Dr
Suite 201
Bethel Park, PA 15102-1841

Mailing address

2000 Oxford Dr
Suite 201
Bethel Park, PA 15102-1841
Phone (412) 831-7570

Other identifiers 1

IdentifierTypeStateIssuer
0015913200011MedicaidPA

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
I20101214000804 PA Practitioner - Otolaryngology 6305033580 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD058860LPAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Hills ENT Association Otolaryngology CurrentSince Oct 3, 1996 Accepting new patients
Guthrie Medical Group, P.C. Current Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Nov 14, 2022 Accepting new patients
Guthrie Medical Group, P.C. Otolaryngology CurrentSince Nov 14, 2022 Accepting new patients

Locations

2000 Oxford Dr
Ste 201
Bethel Park, PA 15102
Phone (412) 831-7570

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

116 S Elmer Ave
Sayre, PA 18840
Phone (570) 887-2849

Interoperability endpoints

  • Direct secure messaging: swawrose181964@direct-guthrie.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459296000000",
    "number": "1013942564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 OXFORD DR",
            "address_2": "SUITE 201",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "151021841",
            "telephone_number": "412-831-7570",
            "fax_number": "412-854-6149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 OXFORD DR",
            "address_2": "SUITE 201",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "151021841",
            "telephone_number": "412-831-7570",
            "fax_number": "412-854-6149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAWROSE",
        "first_name": "STEPHEN",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2016-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD058860L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015913200011",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel Park, PA

Sources for this page

Verify at the official NPI Registry.