Individual provider Active NPI

Jonathan Triantafyllou, M.D.

  • Family Medicine Physician
  • Elizabethtown, PA
National Provider Identifier
1174900666
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD468412 Issued in PA
Practice address
1 Continental Dr
Elizabethtown, PA 17022-2231
Phone
(717) 361-0666
Fax
(717) 361-0202
NPI assigned
May 4, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X R5946 TX
Family Medicine Physician 207Q00000X MD468412 PA Primary

Addresses

Primary practice location

1 Continental Dr
Elizabethtown, PA 17022-2231

Mailing address

PO Box 858
MC Ca410
Hershey, PA 17033-0858
Phone (800) 243-1455

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
I20191004001674 PA Practitioner - Family Practice 8921391467 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD468412PAMDFamily Medicine Physician
R5946TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palliative Medicine Consultants Family Medicine CurrentSince Feb 5, 2024 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients
The Milton S Hershey Medical Center Physician Group CurrentSince Oct 1, 2019 Accepting new patients
Milton S Hershey Medical Center Physicians Group Family Medicine CurrentSince Oct 1, 2019 Accepting new patients

Locations

1 Continental Dr
Elizabethtown, PA 17022
Phone (717) 361-0666

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

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

685 Good Dr
Lancaster, PA 17601
Phone (717) 295-3900

4075 Old Harrisburg Pike
Mount Joy, PA 17552
Phone (717) 735-9661

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": "1430697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1174900666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 858",
            "address_2": "MC CA410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330858",
            "telephone_number": "800-243-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CONTINENTAL DR",
            "city": "ELIZABETHTOWN",
            "state": "PA",
            "postal_code": "170222231",
            "telephone_number": "717-361-0666",
            "fax_number": "717-361-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIANTAFYLLOU",
        "first_name": "JONATHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-04",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R5946",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD468412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, PA

Sources for this page

Verify at the official NPI Registry.