NPIMap

Organization Active NPI

Physiciancare, PC

  • Family Medicine Physician
  • Laceyville, PA
National Provider Identifier
1023272333
Registry record updated Aug 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PHYSICIANCARE, PC
Practice address
104 Main St.
Laceyville, PA 18623
Phone
(570) 869-2988
Fax
(570) 869-2891
NPI assigned
Jul 16, 2008
Last updated
Aug 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2011

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

Authorized official

Name
Lawrence Tama, MD
Title
President/Owner
Phone
(570) 265-6300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

104 Main St.
Laceyville, PA 18623

Mailing address

71 Hospital Drive
Towanda, PA 18848-9706
Phone (570) 265-6300

Other identifiers 2

IdentifierTypeStateIssuer
100755672MedicaidPA
1007556720029MedicaidPA

Other names 1

  • Laceyville Office Other name

National Provider Directory

National Provider Directory
Tax ID family
Physiciancare PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

71 Hospital Dr
Towanda, PA 18848
Phone (717) 265-6300

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312329600000",
    "number": "1023272333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 HOSPITAL DRIVE",
            "city": "TOWANDA",
            "state": "PA",
            "postal_code": "188489706",
            "telephone_number": "570-265-6300",
            "fax_number": "570-268-2807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 MAIN ST.",
            "city": "LACEYVILLE",
            "state": "PA",
            "postal_code": "18623",
            "telephone_number": "570-869-2988",
            "fax_number": "570-869-2891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANCARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-16",
        "last_updated": "2011-08-03",
        "status": "A",
        "authorized_official_last_name": "TAMA",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "570-265-6300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100755672",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007556720029",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laceyville Office",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Laceyville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.