Organization Active NPI

Paul M Izes PC

  • Family Medicine Physician
  • Southampton, PA
National Provider Identifier
1184782328
Registry record updated Apr 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS006987L Issued in PA
Legal business name
PAUL M IZES PC
Practice address
720 2ND Street Pike Ste 105
Southampton, PA 18966-5902
Phone
(215) 322-5575
Fax
(215) 322-6806
NPI assigned
Dec 4, 2006
Last updated
Apr 8, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2009

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

Authorized official

Name
Dr. Paul M Izes, DONPI 1871684944
Title
Physician
Phone
(215) 322-5575

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS006987L PA Primary

Addresses

Primary practice location

720 2ND Street Pike Ste 105
Southampton, PA 18966-5902

Mailing address

720 2ND Street Pike Ste 105
Southampton, PA 18966-5902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101112000044 PA Part B Supplier - Clinic/Group Practice 7214122514 Receives reassigned benefits from 1 practitioner
Practice locations: Southampton, PA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0976704Paul M Izes DO720 Second Street Pike Suite 105, Southampton, PA 18966Certificate of waiverAug 10, 2024

National Provider Directory

National Provider Directory

Locations

720 2nd Street Pike
Ste 105
Southampton, PA 18966
Phone (215) 322-5575

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239148800000",
    "number": "1184782328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 2ND STREET PIKE STE 105",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189665902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 2ND STREET PIKE STE 105",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189665902",
            "telephone_number": "215-322-5575",
            "fax_number": "215-322-6806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL M IZES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2009-04-08",
        "status": "A",
        "authorized_official_last_name": "IZES",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "215-322-5575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS006987L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southampton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.