NPIMap

Organization Active NPI

Pocono Ambulatory Surgery Center LTD

  • Ambulatory Surgical Clinic/Center
  • Stroudsburg, PA
National Provider Identifier
1265435176
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
16821500 Issued in PA
Legal business name
POCONO AMBULATORY SURGERY CENTER LTD
Practice address
1 Veterans PL
Stroudsburg, PA 18360-2418
Phone
(570) 421-4978
Fax
(570) 424-7312
NPI assigned
May 24, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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

Authorized official

Name
Dr. Joseph B Conahan, M.D.
Title
Managing Director
Phone
(570) 421-4978

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 16821500 PA Primary

Addresses

Primary practice location

1 Veterans PL
Stroudsburg, PA 18360-2418

Mailing address

1 Veterans PL
Stroudsburg, PA 18360-2418
Phone (570) 421-4978

Other identifiers 8

IdentifierTypeStateIssuer
075186OtherPAFIRST PRIORITY HEALTH PRO
2175169OtherPAUNITED HEALTHCARE PROVIDE
A1985647OtherPAOXFORD PROVIDER NUMBER
0078006230002MedicaidPA
22777OtherPAGEISINGER PROVIDER NUMBER
78251OtherPAMED PLUS PROVIDER NUMBER
303901OtherPABLUE CROSS PROVIDER NUMBE
8496212OtherPAAETNA PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080428000289 PA Part B Supplier - Ambulatory Surgical Center 5799863064 Practice locations: Stroudsburg, PA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Pocono Ambulatory Surgery Center LTDCCN 39C0001020
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

1 Storm St
Stroudsburg, PA 18360
Phone (570) 421-4978

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1265435176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 VETERANS PL",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183602418",
            "telephone_number": "570-421-4978",
            "fax_number": "570-424-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VETERANS PL",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183602418",
            "telephone_number": "570-421-4978",
            "fax_number": "570-424-7312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POCONO AMBULATORY SURGERY CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "CONAHAN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "570-421-4978",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PA",
            "license": "16821500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH PRO",
            "identifier": "075186",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE PROVIDE",
            "identifier": "2175169",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD PROVIDER NUMBER",
            "identifier": "A1985647",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0078006230002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER PROVIDER NUMBER",
            "identifier": "22777",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED PLUS PROVIDER NUMBER",
            "identifier": "78251",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBE",
            "identifier": "303901",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "8496212",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stroudsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.