Individual provider Active NPI

Jon Kogod Sternburg, MD

  • Family Medicine Physician
  • Honesdale, PA
National Provider Identifier
1083675870
Registry record updated Nov 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD025493E Issued in PA
Practice address
1839 Fair Ave
Honesdale, PA 18431-2121
Phone
(570) 251-6500
Fax
(570) 253-8174
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD025493E PA Primary
Family Medicine Physician 207Q00000X 1471641 NY

Addresses

Primary practice location

1839 Fair Ave
Honesdale, PA 18431-2121

Mailing address

1839 Fair Ave
Honesdale, PA 18431-2121
Phone (570) 251-6500

Other identifiers 6

IdentifierTypeStateIssuer
00679718MedicaidNY
29942OtherGEISINGER HEALH PLAN ID
69A131OtherNYBLUE SHIELD ID NUMBER
000835304MedicaidPA
002313OtherFIRST PRIORITY HEALTH ID
ST415829OtherPABLUE SHIELD ID NUMBER

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

State licenses

LicenseStateTypeSpecialty
1471641NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Physicians, LTD Family Medicine Past Accepting new patients

Organizations & group practices 3

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257465600000",
    "number": "1083675870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 FAIR AVE",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184312121",
            "telephone_number": "570-251-6500",
            "fax_number": "570-253-8174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 FAIR AVE",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184312121",
            "telephone_number": "570-251-6500",
            "fax_number": "570-253-8174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERNBURG",
        "first_name": "JON",
        "middle_name": "KOGOD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2009-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD025493E",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "1471641",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00679718",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALH PLAN ID",
            "identifier": "29942",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD ID NUMBER",
            "identifier": "69A131",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000835304",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH ID",
            "identifier": "002313",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD ID NUMBER",
            "identifier": "ST415829",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honesdale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; 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.