Active NPI
Steven L Delaveris, D.O.
- Family Medicine Physician
- York, PA
National Provider Identifier
1104820968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OS015993
- Practice address
- 1001 S George St
4TH Floor
York, PA 17403-3676 - Phone
- (717) 851-4005
- Fax
- (717) 812-2495
- NPI assigned
- Jun 9, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34002980 | OH | |
| Family Medicine Physician | 207Q00000X | OS015993 | PA | Primary |
Addresses
Primary practice location
1001 S George St
4TH Floor
York, PA 17403-3676
Mailing address
3421 Concord Rd
York, PA 17402-9001
Phone (717) 851-4005
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30138237 | Other | PA | AMERIHEALTH MERCY-WMG |
| P011615 | Other | PA | GATEWAY |
| 0426319 | Medicaid | OH | |
| 102760930 | Medicaid | PA | |
| 1612045 | Other | PA | GATEWAY |
| 30138238 | Other | PA | AMERIHEALTH MERCY-WMG |
| 730183 | Other | PA | HIGHMARK BLUE SHIELD |
| 418789 | Other | PA | UPMC |
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2980 | OH | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Millhon Clinic, Inc | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465776000000",
"number": "1104820968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3421 CONCORD RD",
"city": "YORK",
"state": "PA",
"postal_code": "174029001",
"telephone_number": "717-851-4005",
"fax_number": "717-812-2495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 S GEORGE ST",
"address_2": "4TH FLOOR",
"city": "YORK",
"state": "PA",
"postal_code": "174033676",
"telephone_number": "717-851-4005",
"fax_number": "717-812-2495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELAVERIS",
"first_name": "STEVEN",
"middle_name": "L",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-09",
"last_updated": "2016-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "34002980",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "OS015993",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH MERCY-WMG",
"identifier": "30138237",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY",
"identifier": "P011615",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0426319",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102760930",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY",
"identifier": "1612045",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH MERCY-WMG",
"identifier": "30138238",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "730183",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UPMC",
"identifier": "418789",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in York, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.