John Samuel Halcovage, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS-008090-L Issued in PA

Practice address

1700 South Lincoln Avenue
Lebanon, PA 17042

Phone

(717) 272-6621

Fax

(717) 228-6045

NPI assigned

Mar 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1174582266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 ACADEMY DRIVE",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171121091",
            "telephone_number": "717-652-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SOUTH LINCOLN AVENUE",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "17042",
            "telephone_number": "717-272-6621",
            "fax_number": "717-228-6045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALCOVAGE",
        "first_name": "JOHN",
        "middle_name": "SAMUEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS-008090-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01529584",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Hahn
• Jennifer Ann Hailey, PSY.D.
• Randall Craig Haines
• Brian Hains
• Leanne Michelle Hains, PT
• Lyndsey Haldeman
• Marion J Haligowski III, OD
• Marta Halytska, MD
• Lisa Ann Hamaker, CRNP
• Jessica Hamby, LCSW

• Internal Medicine Physician in Lebanon, PA
• Providers in Lebanon, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.