NPIMap

Individual provider Active NPI

Paul Jerome Palafox Custodio, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • New Kensington, PA
National Provider Identifier
1093997280
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
MD456308 Issued in PA
Practice address
356 Freeport St
New Kensington, PA 15068-6071
Phone
(724) 367-2400
Fax
(724) 367-2401
NPI assigned
Nov 29, 2007
Last updated
Oct 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD456308 PA Primary

Addresses

Primary practice location

356 Freeport St
New Kensington, PA 15068-6071

Mailing address

356 Freeport St
New Kensington, PA 15068-6071
Phone (724) 367-2400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pcustodio25929@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY, OH3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20161026002469 PA Practitioner - Endocrinology 8123306164 Reassigns benefits to 4 organizations
I20210303000988 NY Practitioner - Endocrinology 8123306164 Reassigns benefits to 1 organization
I20241204001798 OH Practitioner - Endocrinology 8123306164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Susquehanna Physician ServicesGroup PAC ID 2264336460, 611 clinicians
Summa Physicians LLCGroup PAC ID 2961303532, 692 clinicians
Fornance Physician Services IncGroup PAC ID 8527962661, 105 clinicians

Practice addresses (Care Compare)

1100 Grampian Blvd
Williamsport, PA 17701-1909
Phone (570) 320-7848

45 Arch St
Akron, OH 44304-1403

525 E Market St
Akron, OH 44304-1619

559 W Germantown Pike
East Norriton, PA 19403-4250
Phone (484) 622-1000

95 Arch St
Suite 215
Akron, OH 44304-1467
Phone (330) 434-4145

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD456308PAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fornance Physician Services, Inc Current Accepting new patients
Allegheny Clinic Current Accepting new patients
Susquehanna Physician Services CurrentSince Nov 4, 2024 Accepting new patients
Fornance Physician Services, Inc Endocrinology, Diabetes & Metabolism CurrentSince Nov 1, 2023 Accepting new patients
Susquehanna Physician Services Endocrinology, Diabetes & Metabolism CurrentSince Nov 4, 2024 Accepting new patients
Allegheny Clinic CurrentSince Oct 6, 2016 Accepting new patients
Summa Physicians LLC Current Accepting new patients
Einstein Practice Plan Inc CurrentSince Jan 1, 2026 Accepting new patients
Allegheny Clinic Endocrinology, Diabetes & Metabolism CurrentSince Oct 6, 2016 Accepting new patients
Einstein Practice Plan Inc CurrentSince Jan 1, 2026 Accepting new patients
Summa Physicians LLC CurrentSince Jan 1, 2025 Accepting new patients
Fornance Physician Services, Inc. CurrentSince Nov 1, 2023 Accepting new patients
Chautauqua Medical Practice, P.C. CurrentSince Feb 1, 2021 Accepting new patients
Summa Physicians LLC CurrentSince Jan 1, 2025 Accepting new patients
Mochi Medical Ca PC Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Allegheny Clinic Past Accepting new patients

Locations

189 E Main St
Westfield, NY 14787
Phone (716) 326-4921

1077 Gorge Blvd
Akron, OH 44310
Phone (234) 312-5691

525 E Market St
Akron, OH 44304
Phone (330) 375-6350

60 Township Line Rd
Elkins Park, PA 19027
Phone (215) 663-6000

153 E 13th St
Ste 1300
Erie, PA 16503
Phone (814) 452-5081

210 Mall Blvd
Ste G03
King of Prussia, PA 19406
Phone (610) 233-3699

1900 Waterdam Plaza Dr
Ste 2
McMurray, PA 15317
Phone (724) 260-7531

1900 Waterdam Plaza Dr
Ste 3
McMurray, PA 15317
Phone (412) 559-8003

356 Freeport St
New Kensington, PA 15068
Phone (724) 335-8223

651 4th Ave
New Kensington, PA 15068
Phone (724) 334-4710

5401 Old York Rd
Ste 331
Philadelphia, PA 19141
Phone (215) 456-6948

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

320 E North Ave
Pittsburgh, PA 15212
Phone (412) 359-3131

701 Broad St
Ste 431
Sewickley, PA 15143
Phone (412) 741-0966

559 W Germantown Pike
West Norriton, PA 19403
Phone (484) 622-1000

1100 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8005

1201 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8723

700 High St
Williamsport, PA 17701
Phone (570) 321-2000

Interoperability endpoints

  • Direct secure messaging: paul.j.custodio@upmcdirect.com
  • Direct secure messaging: pcustodio25929@direct.ahn.org
  • Direct secure messaging: pcustodio429608@upmc.direct-ci.com

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1093997280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 FREEPORT ST",
            "city": "NEW KENSINGTON",
            "state": "PA",
            "postal_code": "150686071",
            "telephone_number": "724-367-2400",
            "fax_number": "724-367-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 FREEPORT ST",
            "city": "NEW KENSINGTON",
            "state": "PA",
            "postal_code": "150686071",
            "telephone_number": "724-367-2400",
            "fax_number": "724-367-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSTODIO",
        "first_name": "PAUL JEROME",
        "middle_name": "PALAFOX",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-29",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "PA",
            "license": "MD456308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcustodio25929@direct.ahn.org",
            "affiliation": "N",
            "address_1": "356 Freeport St",
            "city": "New Kensington",
            "state": "PA",
            "country_code": "US",
            "postal_code": "150686071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Kensington, PA

Sources for this page

Verify at the official NPI Registry.