NPIMap

Individual provider Active NPI

Peter Cartaginese, MD

  • Internal Medicine Physician
  • Dushore, PA
National Provider Identifier
1104890375
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD034562E Issued in PA
Practice address
110 Main Street
Box 417
Dushore, PA 18614
Phone
(570) 928-8146
Fax
(570) 928-7488
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD034562E PA Primary

Addresses

Primary practice location

110 Main Street
Box 417
Dushore, PA 18614

Mailing address

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858

Other identifiers 3

IdentifierTypeStateIssuer
00947764MedicaidNY
0010367050001MedicaidPA
CC9269OtherPARR MEDICARE GROUP

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD034562EPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Clinic LTD Past Accepting new patients
Guthrie Medical Group, P.C. Past Accepting new patients
Philadelphia College of Osteopathic Medicine Internal Medicine PastSince Sep 23, 2021 Accepting new patients
Guthrie Medical Group, P.C. Internal Medicine Past Accepting new patients
Guthrie Medical Group, P.C. Internal Medicine Past Accepting new patients

Organizations & group practices 5

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1104890375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858",
            "fax_number": "570-882-2094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MAIN STREET",
            "address_2": "BOX 417",
            "city": "DUSHORE",
            "state": "PA",
            "postal_code": "18614",
            "telephone_number": "570-928-8146",
            "fax_number": "570-928-7488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTAGINESE",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD034562E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00947764",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010367050001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "CC9269",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dushore, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.