Active NPI
Thaddeus Raymond Szydlowski, M.D.
- Gastroenterology Physician
- Lebanon, PA
National Provider Identifier
1053304352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- MD014356E
- Practice address
- 761 Norman Dr
Lebanon, PA 17042-7497 - Phone
- (717) 376-1180
- Fax
- (717) 273-6937
- NPI assigned
- Aug 23, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | MD014356E | PA | Primary |
Addresses
Primary practice location
761 Norman Dr
Lebanon, PA 17042-7497
Mailing address
PO Box 300
Lebanon, PA 17042-0300
Phone (717) 270-7780
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 91402 | Other | HIGHMARK BLUE SHIELD | |
| 50046058 | Other | CAPITAL BLUE CROSS | |
| 151298 | Other | GATEWAY HEALTH PLAN | |
| 0006698670002 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lebanon MRI Associates, LTD | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Magnetic Resonance Imaging (MRI) Clinic/Center
- Lebanon, PA
- NPI 1912940651
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416528000000",
"number": "1053304352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 300",
"city": "LEBANON",
"state": "PA",
"postal_code": "170420300",
"telephone_number": "717-270-7780",
"fax_number": "717-274-9746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "761 NORMAN DR",
"city": "LEBANON",
"state": "PA",
"postal_code": "170427497",
"telephone_number": "717-376-1180",
"fax_number": "717-273-6937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SZYDLOWSKI",
"first_name": "THADDEUS",
"middle_name": "RAYMOND",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-23",
"last_updated": "2014-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "PA",
"license": "MD014356E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "91402",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "50046058",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY HEALTH PLAN",
"identifier": "151298",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0006698670002",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, PA
- Jennifer Swanson
- Jerome Swierczynski, CRNA
- Charles Marvin Swingholm, R.N.
- Jennifer Lyn Swope, LCSW
- Michael Sze, MD
- T. W. Ponessa and Associates Counseling Services, Inc.
- T. W. Ponessa and Associates Counseling Services, Inc.
- T. W. Ponessa and Associates Counseling Services, Inc.
- T. W. Ponessa and Associates Counseling Services, Inc.
- T. W. Ponessa and Associates Counseling Services, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.