Individual provider Active NPI

Lindy Lee Cibischino, MD

  • Pediatrics Physician
  • Stroudsburg, PA
National Provider Identifier
1063407575
Registry record updated May 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD060024L Issued in PA
Practice address
208 Lifeline Rd
Ste 201
Stroudsburg, PA 18360-7566
Phone
(570) 476-6700
Fax
(570) 476-0124
NPI assigned
Sep 12, 2005
Last updated
May 2, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD060024L PA Primary

Addresses

Primary practice location

208 Lifeline Rd
Ste 201
Stroudsburg, PA 18360-7566

Mailing address

208 Lifeline Rd
Ste 201
Stroudsburg, PA 18360-7566
Phone (570) 476-6700

Other identifiers 1

IdentifierTypeStateIssuer
001603020001MedicaidPA

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
I20200130002185 PA Practitioner - Pediatric Medicine 1759529696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD060024LPAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Physician Group, Inc. CurrentSince Dec 11, 2019 Accepting new patients
St. Luke's Physician Group, Inc. Current Accepting new patients
St Luke's Physician Group Inc CurrentSince Dec 11, 2019 Accepting new patients
St. Luke's Physician Group, Inc. Past Accepting new patients

Locations

4311 Easton Ave
Bethlehem, PA 18020
Phone (610) 954-3600

125 Smithfield Ln
East Stroudsburg, PA 18301
Phone (272) 212-3872

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

174 Harvest Ln
Pocono Summit, PA 18346
Phone (272) 639-5415

208 Lifeline Rd
Ste 201
Stroudsburg, PA 18360
Phone (570) 476-6700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367452800000",
    "number": "1063407575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 LIFELINE RD",
            "address_2": "STE 201",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183607566",
            "telephone_number": "570-476-6700",
            "fax_number": "570-476-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 LIFELINE RD",
            "address_2": "STE 201",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183607566",
            "telephone_number": "570-476-6700",
            "fax_number": "570-476-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIBISCHINO",
        "first_name": "LINDY LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-12",
        "last_updated": "2013-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD060024L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001603020001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stroudsburg, PA

Sources for this page

Verify at the official NPI Registry.