NPIMap

Organization Active NPI

Pocono Advanced Medical Clinic PC

  • Specialist
  • East Stroudsburg, PA
National Provider Identifier
1053668798
Registry record updated Aug 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD444372 Issued in PA
Legal business name
POCONO ADVANCED MEDICAL CLINIC PC
Practice address
144 E Brown St
East Stroudsburg, PA 18301-2922
Phone
(570) 424-1105
NPI assigned
Aug 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2012

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

Authorized official

Name
Mihaela F Hangan, MDNPI 1013237627
Title
President
Phone
(570) 424-1105

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X MD444372 PA Primary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X MD444904 PA

Addresses

Primary practice location

144 E Brown St
East Stroudsburg, PA 18301-2922

Mailing address

144 E Brown St
East Stroudsburg, PA 18301-2922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120917000245 PA Part B Supplier - Clinic/Group Practice 8022266071 Receives reassigned benefits from 1 practitioner
Practice locations: East Stroudsburg, PA

National Provider Directory

National Provider Directory

Locations

600 Plaza Ct
Ste A
East Stroudsburg, PA 18301
Phone (570) 517-0511

175 E Brown St
Ste 203
East Stroudsburg, PA 18301
Phone (570) 424-1105

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344816000000",
    "number": "1053668798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 E BROWN ST",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183012922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 E BROWN ST",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183012922",
            "telephone_number": "570-424-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POCONO ADVANCED MEDICAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-13",
        "last_updated": "2012-08-13",
        "status": "A",
        "authorized_official_last_name": "HANGAN",
        "authorized_official_first_name": "MIHAELA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-424-1105",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD444372",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD444904",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Stroudsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; 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.