NPIMap

Individual provider Active NPI

Krista Bott, M.D.

  • Surgery Physician
  • Stroudsburg, PA
National Provider Identifier
1104051200
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD451073 Issued in PA
Practice address
600 Commerce Blvd
3Rd Floor
Stroudsburg, PA 18360-6214
Phone
(570) 426-6070
Fax
(570) 422-8091
NPI assigned
May 19, 2009
Last updated
May 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MT194819 PA
Surgery Physician 208600000X MD451073 PA Primary

Addresses

Primary practice location

600 Commerce Blvd
3Rd Floor
Stroudsburg, PA 18360-6214

Mailing address

206 E Brown St
Pocono Health System - Professional Center
East Stroudsburg, PA 18301-3006
Phone (570) 420-4919

Other practice location 1

3794 Hecktown Rd Ste 130
Easton, PA 18045-2355
Phone (484) 544-4777

Other practice location 2

300 Lackawanna Ave Ste 200
Scranton, PA 18503-2001
Phone (570) 342-7864

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140828000073 PA Practitioner - General Surgery 3779720677 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Jefferson Medical College of Thomas Jefferson University, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

3794 Hecktown Rd
Suite 250
Easton, PA 18045-2355
Phone (484) 546-5800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy62
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Jul 1, 2021 Accepting new patients
Family Care Centers Inc CurrentSince Aug 22, 2016 Accepting new patients
Lehigh Valley Physician Group Surgery Current Accepting new patients
Family Care Centers Inc. Surgery Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Jul 1, 2021 Accepting new patients
Vascular Diagnostic Center PC Past Accepting new patients
Pathology Associates of NE PA LTD PastSince Aug 18, 2014 Accepting new patients

Locations

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

500 Plaza Ct
East Stroudsburg, PA 18301
Phone (570) 426-2330

500 Plaza Ct
Ste A
East Stroudsburg, PA 18301
Phone (570) 424-9970

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

300 Lackawanna Ave
Ste 200
Scranton, PA 18503
Phone (570) 342-7864

5 Morgan Hwy
Ste 7
Scranton, PA 18508
Phone (570) 342-7864

600 Commerce Blvd
Fl 3
Stroudsburg, PA 18360
Phone (570) 426-6070

Interoperability endpoints

  • Direct secure messaging: kbott@poconomc.direct.varian.com
  • Direct secure messaging: kgoodman111830@direct2.lvhn.org

Organizations & group practices 8

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.

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1104051200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 E BROWN ST",
            "address_2": "POCONO HEALTH SYSTEM - PROFESSIONAL CENTER",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183013006",
            "telephone_number": "570-420-4919",
            "fax_number": "570-426-2643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 COMMERCE BLVD",
            "address_2": "3RD FLOOR",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183606214",
            "telephone_number": "570-426-6070",
            "fax_number": "570-422-8091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3794 Hecktown Rd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Easton",
            "state": "PA",
            "postal_code": "180452355",
            "country_code": "US",
            "telephone_number": "484-544-4777",
            "fax_number": "484-544-0185",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Lackawanna Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Scranton",
            "state": "PA",
            "postal_code": "185032001",
            "country_code": "US",
            "telephone_number": "570-342-7864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOTT",
        "first_name": "KRISTA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-19",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT194819",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD451073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stroudsburg, PA

Sources for this page

Verify at the official NPI Registry.