Active NPI
Charles Dinerstein, MD
- Vascular Surgery Physician
- Lebanon, PA
National Provider Identifier
1255336715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- MA048088
- Practice address
- 4TH & Walnut Streets
2ND Floor
Lebanon, PA 17042-6123 - Phone
- (717) 270-3751
- Fax
- (270) 270-3754
- NPI assigned
- Jun 20, 2005
- Last updated
- Dec 3, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | MA048088 | NJ | Primary |
Addresses
Primary practice location
4TH & Walnut Streets
2ND Floor
Lebanon, PA 17042-6123
Mailing address
PO Box 300
Lebanon, PA 17042-0300
Phone (717) 270-7780
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102760804001 | Medicaid | PA | |
| 3967000 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA048088 | NJ | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| James F McGuckin MD of NJ PA | Past | Accepting new patients | |
| Vascular Access Center of Trenton LLC | Past | Accepting new patients | |
| Lebanon MRI Associates, LTD | Past | Accepting new patients |
Organizations & group practices 3
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.
-
dba GSH Imaging Center
- Magnetic Resonance Imaging (MRI) Clinic/Center
- Lebanon, PA
- NPI 1912940651
-
- Vascular & Interventional Radiology Physician
- Mays Landing, NJ
- NPI 1265670632
-
- Vascular & Interventional Radiology Physician
- Trenton, NJ
- NPI 1740234301
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417564800000",
"number": "1255336715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 300",
"city": "LEBANON",
"state": "PA",
"postal_code": "170420300",
"telephone_number": "717-270-7780",
"fax_number": "717-274-9746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4TH & WALNUT STREETS",
"address_2": "2ND FLOOR",
"city": "LEBANON",
"state": "PA",
"postal_code": "170426123",
"telephone_number": "717-270-3751",
"fax_number": "270-270-3754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DINERSTEIN",
"first_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-20",
"last_updated": "2014-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "NJ",
"license": "MA048088",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102760804001",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3967000",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lebanon, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.