Paul W. Bisio, D.O.

Individual provider Active NPI Family Medicine Physician · Mount Pocono, PA

NPI 1245205608 · NPPES record last updated Mar 9, 2016

Key facts

NPI
1245205608
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
OS009607L (PA)
Practice address
21 Commerce Cir
Mount Pocono, PA 18344-1362
Phone
(570) 839-3633
Fax
(570) 839-6490
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in PA, NJ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20050607001142 PA Practitioner - Family Practice 9234172594
I20180426000481 NJ Practitioner - Family Practice 9234172594

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS009607L PA Yes

Addresses

Primary practice location

21 Commerce Cir
Mount Pocono, PA 18344-1362

Mailing address

100 N Academy Ave
Danville, PA 17822-3034
Phone (570) 271-6144

Other identifiers

IdentifierTypeStateIssuer
001864580MedicaidPA

Other providers in Mount Pocono, PA

All providers in Mount Pocono, PA · Family Medicine Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.