Individual provider Active NPI

Charles Dinerstein, MD

  • Vascular Surgery Physician
  • Lebanon, PA
National Provider Identifier
1255336715
Registry record updated Dec 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MA048088 Issued in NJ
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, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
102760804001MedicaidPA
3967000MedicaidNJ

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

LicenseStateTypeSpecialty
MA048088NJMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
James F McGuckin MD of NJ PA Past Accepting new patients
Vascular Access Center of Trenton LLC PastSince Feb 1, 2017 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.

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.

Verify at the official NPI Registry.