Individual provider Active NPI

George P Desjardins

  • Emergency Medicine Physician
  • Reading, PA
National Provider Identifier
1114979333
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD016520E Issued in PA
Practice address
215 N 12TH St
Reading, PA 19604-2915
Phone
(610) 371-7700
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD016520E PA Primary

Addresses

Primary practice location

215 N 12TH St
Reading, PA 19604-2915

Mailing address

1211 Elm St
Reading, PA 19604-2927
Phone (610) 371-7700

Other identifiers 1

IdentifierTypeStateIssuer
0977490MedicaidPA

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 Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ephrata Community Hospital Current Accepting new patients
Premier Immediate Medical Care, LLC PastSince Jan 5, 2006 Accepting new patients
Berks Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
St. Joseph Regional Health Network Emergency Medicine Past Accepting new patients

Locations

169 Martin Ave
Ephrata, PA 17522
Phone (717) 733-0311

Organizations & group practices 4

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114979333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 ELM ST",
            "city": "READING",
            "state": "PA",
            "postal_code": "196042927",
            "telephone_number": "610-371-7700",
            "fax_number": "610-371-9189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N 12TH ST",
            "city": "READING",
            "state": "PA",
            "postal_code": "196042915",
            "telephone_number": "610-371-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESJARDINS",
        "first_name": "GEORGE",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD016520E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0977490",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reading, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.