NPIMap

Individual provider Active NPI

Eric P Wilson, M.D.

  • Vascular Surgery Physician
  • Stroudsburg, PA
National Provider Identifier
1114927597
Registry record updated Sep 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD050400L Issued in PA
Practice address
600 Commerce Blvd
Stroudsburg, PA 18360-6214
Phone
(570) 426-2960
Fax
(570) 426-2965
NPI assigned
Jul 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X MD050400L PA Primary

Addresses

Primary practice location

600 Commerce Blvd
Stroudsburg, PA 18360-6214

Mailing address

1259 S Cedar Crest Blvd
Suite 301
Allentown, PA 18103-6206
Phone (610) 439-0372

Other identifiers 2

IdentifierTypeStateIssuer
040962PZPOtherMEDICARE
0018144070004MedicaidPA

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
I20100608000361 PA Practitioner - Vascular Surgery 0244272524 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 1989
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)

1259 S Cedar Crest Blvd
301 LVPG Vascular Surgery
Allentown, PA 18103-6260
Phone (610) 439-0372

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal20
Leg revascularization (restoring blood flow)22
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Centers Inc. Current Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Aug 12, 2021 Accepting new patients
Lehigh Valley Physician Group CurrentSince Aug 12, 2021 Accepting new patients
Family Care Centers Inc CurrentSince May 1, 2015 Accepting new patients
Peripheral Vascular Surgeons, PC Vascular Surgery Past Accepting new patients

Locations

1251 S Cedar Crest Blvd
Ste 301
Allentown, PA 18103
Phone (610) 437-0711

1503 N Cedar Crest Blvd
Allentown, PA 18104
Phone (610) 871-9110

1259 S Cedar Crest Blvd
Ste 301
Allentown, PA 18103
Phone (610) 402-9400

2100 Mack Blvd
Fl 2
Allentown, PA 18103

2775 Schoenersville Rd
Bethlehem, PA 18017

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

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

500 Plaza Ct
Ofc Plz
East Stroudsburg, PA 18301
Phone (570) 420-2188

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

281 N 12th St
Lehighton, PA 18235
Phone (610) 377-0990

292 Frantz Rd
Ste 102
Stroudsburg, PA 18360
Phone (570) 395-2502

600 Commerce Blvd
Stroudsburg, PA 18360
Phone (570) 424-7390

Interoperability endpoints

  • Direct secure messaging: ewilson115626@direct2.lvhn.org

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lehigh Valley Hospital PoconoEast Stroudsburg, PA, CCN 390201 Hospital Corporate Officer Jul 1, 2025
Lehigh Valley Hospital PoconoEast Stroudsburg, PA, CCN 39T201 Hospital Corporate Officer Jul 1, 2025
Lehigh Valley Hospital - Dickson CityDickson City, PA, CCN 390338 Hospital Corporate Officer Jul 1, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1114927597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1259 S CEDAR CREST BLVD",
            "address_2": "SUITE 301",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036206",
            "telephone_number": "610-439-0372",
            "fax_number": "610-439-8807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 COMMERCE BLVD",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183606214",
            "telephone_number": "570-426-2960",
            "fax_number": "570-426-2965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ERIC",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "MD050400L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "040962PZP",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018144070004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stroudsburg, PA

Sources for this page

Verify at the official NPI Registry.