Thomas John Pietras, DO
Individual provider Active NPI Diagnostic Radiology Physician · Lewisberry, PA
NPI 1104812007 · NPPES record last updated Jan 17, 2012
Key facts
- NPI
- 1104812007
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 05005250L (PA)
- Practice address
- 629D Lowther Rd
Lewisberry, PA 17339-9527 - Phone
- (717) 932-5200
- Fax
- (717) 932-3095
- NPI assigned
- Sep 26, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05005250L | PA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upmc Pinnacle Hospitals | Past | Accepting new patients | |
| Central Pennsylvania MRI Center | Diagnostic Radiology | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 05005250L | PA | Yes |
Addresses
Primary practice location
629D Lowther Rd
Lewisberry, PA 17339-9527
Mailing address
629D Lowther Rd
Lewisberry, PA 17339-9527
Phone (717) 932-5200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000994285 | Medicaid | PA |
Other providers in Lewisberry, PA
- Nicholas Otto
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- Benjamin O Pelleschi
- Todd M Pelleschi
- Jason Pennypacker
- Christoph Pohl
- Paul Steven Potok
- Kelechi Princewill
- Quantum Imaging & Therapeutic Associates Inc
- Quantum Imaging & Therapeutic Associates, Inc
All providers in Lewisberry, PA · Diagnostic Radiology Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.