Individual provider Active NPI

Parvez Memon, M.D.

  • Family Medicine Physician
  • Stroudsburg, PA
National Provider Identifier
1225181811
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD058888L Issued in PA
Practice address
208 Lifeline Rd Ste 102
Stroudsburg, PA 18360-6473
Phone
(570) 420-5435
Fax
(570) 420-5437
NPI assigned
Jan 19, 2007
Last updated
Jan 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD058888L PA Primary

Addresses

Primary practice location

208 Lifeline Rd Ste 102
Stroudsburg, PA 18360-6473

Mailing address

Route 611 Stroud BLDG
Suite 100B
Stroudsburg, PA 18360-9317
Phone (570) 420-5435

Other identifiers 1

IdentifierTypeStateIssuer
0015887180007MedicaidPA

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
I20120222000383 PA Practitioner - Family Practice 1355440256 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.09 of 100Reported as group
Quality
74.47
Promoting interoperability
86
Improvement activities
40
Cost
74.16

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Centers Inc Family Medicine CurrentSince May 30, 2023 Accepting new patients
Family Care Centers Inc. Family Medicine CurrentSince May 30, 2023 Accepting new patients
Fitzmaurice Community Services Inc Past Accepting new patients

Locations

500 Plaza Ct
East Stroudsburg, PA 18301
Phone (570) 426-2330

292 Frantz Rd
Stroudsburg, PA 18360
Phone (570) 424-7390

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1225181811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ROUTE 611 STROUD BLDG",
            "address_2": "SUITE 100B",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183609317",
            "telephone_number": "570-420-5435",
            "fax_number": "570-420-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 LIFELINE RD STE 102",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183606473",
            "telephone_number": "570-420-5435",
            "fax_number": "570-420-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEMON",
        "first_name": "PARVEZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD058888L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015887180007",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stroudsburg, PA

Sources for this page

Verify at the official NPI Registry.