Individual provider Active NPI

Carol Linda St George, D.O.

  • Otolaryngology Physician
  • York, PA
National Provider Identifier
1134174147
Registry record updated Feb 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
OS004419L Issued in PA
Practice address
1776 S Queen St
York, PA 17403-4628
Phone
(717) 845-6261
Fax
(717) 852-0630
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X OS004419L PA Primary

Addresses

Primary practice location

1776 S Queen St
York, PA 17403-4628

Mailing address

409 S 2ND St Ste 2F
Harrisburg, PA 17104-1612

Other identifiers 3

IdentifierTypeStateIssuer
1338861OtherPAHIGHMARK BLUE SHIELD
01564701OtherPACAPITAL BLUE CROSS
9788350005MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040210000617 PA Practitioner - Otolaryngology 3870487945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Philadelphia College of Osteopathic Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lancaster Ear Nose and Throat LLCGroup PAC ID 1557527017, 4 clinicians

Practice addresses (Care Compare)

930 Red Nose CT
Suite 301
Lancaster, PA 17601-1981
Phone (717) 517-9083

Hospital & facility affiliations

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: cstgeorge89438@direct-lghealth.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519171200000",
    "number": "1134174147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S 2ND ST STE 2F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 S QUEEN ST",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174034628",
            "telephone_number": "717-845-6261",
            "fax_number": "717-852-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST GEORGE",
        "first_name": "CAROL",
        "middle_name": "LINDA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2018-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "OS004419L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1338861",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "01564701",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9788350005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.