Luis A Cervantes, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

MD462928 Issued in PA

Practice address

500 Plaza Court
East Stroudsburg, PA 18301-3124

Phone

(570) 426-2758

Fax

(570) 426-2665

NPI assigned

Jun 23, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Lehigh Valley Physician Group

  • Transplant Surgery Physician
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  • NPI 1457309650

  Neurological Surgery

  NPD

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1215933353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MARTER AVE",
            "address_2": "SUITE 202",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573124",
            "telephone_number": "856-727-1000",
            "fax_number": "856-727-1059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PLAZA COURT",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183013124",
            "telephone_number": "570-426-2758",
            "fax_number": "570-426-2665"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Marter Ave",
            "address_2": "suite 202",
            "address_purpose": "LOCATION",
            "city": "Moorestown",
            "state": "NJ",
            "postal_code": "080573124",
            "country_code": "US",
            "telephone_number": "856-727-1000",
            "fax_number": "856-727-9480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CERVANTES",
        "first_name": "LUIS",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NJ",
            "license": "MA44094",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "PA",
            "license": "MD462928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH HMO",
            "identifier": "0108926000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH ADMINISTRATOR",
            "identifier": "E01236",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1034000720003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "620691PZP",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/USHC",
            "identifier": "34701",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dianne Chelak, DIETICIAN

• Neurological Surgery Physician in East Stroudsburg, PA
• Providers in East Stroudsburg, PA by specialty
• Neurological Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; 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.