Individual provider Active NPI

Paul Gray Lacey, M.D.

  • Gastroenterology Physician
  • Harrisburg, PA
National Provider Identifier
1265432876
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD 044099 L Issued in PA
Practice address
4387 Sturbridge Dr
Harrisburg, PA 17110-3673
Phone
(717) 238-3111
NPI assigned
Jul 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD 044099 L PA Primary

Addresses

Primary practice location

4387 Sturbridge Dr
Harrisburg, PA 17110-3673

Mailing address

423 N 21St St
Suite 100
Camp Hill, PA 17011-2207
Phone (717) 238-3111

Other practice location 1

423 N 21st St
Suite 100
Camp Hill, PA 17011-2207
Phone (717) 238-3111

Other identifiers 6

IdentifierTypeStateIssuer
50058922OtherPACAPITAL BLUE CROSS
739366OtherPAHIGHMARK BLUE SHIELD
P00318652OtherPARAILROAD MEDICARE
4363687OtherPAAETNA US HEALTHCARE
F53848OtherPAHEALTHAMERICA
0014076520002MedicaidPA

Other names 1

  • Dr. Paul Gray Lacey Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address paullacey@jg.allscriptsdirect.net

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
I20060613000101 PA Practitioner - GastroenterologyPractitioner - Internal Medicine 1850303819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Pennsylvania State University College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Siegelbaum Gastroenterology LTDGroup PAC ID 5799769139, 10 clinicians

Practice addresses (Care Compare)

423 N 21St St
Suite 100
Camp Hill, PA 17011-2207
Phone (717) 761-0930

4387 Sturbridge Dr
Harrisburg, PA 17110-3673
Phone (717) 238-3111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy182
Upper gastrointestinal (GI) endoscopy for acid reflux137

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 044099 LPAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Siegelbaum Gastroenterology LTD Gastroenterology CurrentSince Jul 1, 2006 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Capital Anesthesia LLC Past Accepting new patients

Locations

423 N 21st St
Ste 102
Camp Hill, PA 17011
Phone (717) 525-6488

200 Grandview Ave
Ste 101
Camp Hill, PA 17011

423 N 21st St
Ste 100
Camp Hill, PA 17011
Phone (717) 238-3111

4387 Sturbridge Dr
Harrisburg, PA 17110
Phone (717) 238-3111

2626 N 3rd St
Ste 3A
Harrisburg, PA 17110
Phone (717) 238-3111

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DGCHDD

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 and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1265432876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 N 21ST ST",
            "address_2": "SUITE 100",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170112207",
            "telephone_number": "717-238-3111",
            "fax_number": "717-238-1896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4387 STURBRIDGE DR",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171103673",
            "telephone_number": "717-238-3111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "423 N 21st St",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Camp Hill",
            "state": "PA",
            "postal_code": "170112207",
            "country_code": "US",
            "telephone_number": "717-238-3111",
            "fax_number": "717-238-1896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACEY",
        "first_name": "PAUL",
        "middle_name": "GRAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD 044099 L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50058922",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "739366",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00318652",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "4363687",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHAMERICA",
            "identifier": "F53848",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014076520002",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "paullacey@jg.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "4387 Sturbridge Dr",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171103673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "PAUL",
            "last_name": "LACEY",
            "middle_name": "GRAY",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.