Eleanor Banzon Antolin, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD-061175-L Issued in PA

Practice address

206 E Brown St
East Stroudsburg, PA 18301-3006

Phone

(570) 421-4000

Fax

(570) 424-3346

NPI assigned

May 4, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA, NJ2 enrollments

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 2

Specialty

Psychiatry

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lehigh Valley Physician Group 2,512 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lehigh Valley Hospital - Pocono Hospital, East Stroudsburg, PA, CCN 390201
• Lehigh Valley Hospital - Dickson City Hospital, Dickson City, PA, CCN 390338

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Lehigh Valley Physician Group

  • Developmental - Behavioral Pediatrics Physician
  • Allentown, PA
  • NPI 1780155689

  PA

  Medicare reassignment Care Compare group
• Family Care Centers Inc.

  • Internal Medicine Physician
  • E Stroudsburg, PA
  • NPI 1669563037

  PA, Psychiatry

  Medicare reassignment NPD
• Lehigh Valley Physician Group

  • Podiatrist
  • Easton, PA
  • NPI 1013672666
  Care Compare group
• Lehigh Valley Physician Group

  • Diagnostic Radiology Physician
  • Allentown, PA
  • NPI 1033094289
  Care Compare group
• Lehigh Valley Physician Group

  • Durable Medical Equipment & Medical Supplies
  • Dickson City, PA
  • NPI 1174257513
  Care Compare group
• Family Care Centers Inc

  • Family Medicine Physician
  • East Stroudsburg, PA
  • NPI 1316409626
  NPD
• Lehigh Valley Physician Group

  • Family Medicine Physician
  • East Stroudsburg, PA
  • NPI 1245093368
  NPD
• Lehigh Valley Physician Group

  • Obesity Medicine (Internal Medicine) Physician
  • Allentown, PA
  • NPI 1265506166
  NPD
• Lehigh Valley Physician Group

  • Transplant Surgery Physician
  • Allentown, PA
  • NPI 1457309650
  NPD
• Lehigh Valley Hospital Pocono

  • General Acute Care Hospital
  • East Stroudsburg, PA
  • NPI 1568459436
  NPD (past)

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

• Lehigh Valley Hospital Pocono

  • General Acute Care Hospital
  • East Stroudsburg, PA
  • NPI 1568459436

  Hospital

  Care Compare affiliation
• Lehigh Valley Hospital- Pocono

  • General Acute Care Hospital
  • Dickson City, PA
  • NPI 1396402053

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1285846071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR2 BOX 2440",
            "city": "CRESCO",
            "state": "PA",
            "postal_code": "18326",
            "telephone_number": "570-420-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 E BROWN ST",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183013006",
            "telephone_number": "570-421-4000",
            "fax_number": "570-424-3346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 River Road",
            "address_purpose": "LOCATION",
            "city": "Minisink Hills",
            "state": "PA",
            "postal_code": "18341",
            "country_code": "US",
            "telephone_number": "570-420-8601 x195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTOLIN",
        "first_name": "ELEANOR",
        "middle_name": "BANZON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD-061175-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017179400003",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017179400002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olivia Andersen, PHARM.D.
• Elizabeth Marie Anderson
• Abby Jo Andrews, PA-C
• Gregori Peter Anelli
• Anthony R. Harlacher DMD, PC
• M. Ellen Anuszewski, CRNP
• Lyliette Aquino, ATC
• Joseph John Arcuri Jr., M.D.
• Ann Genine Arcurie, MSN, CRNP
• Nicholas Arcury

• All providers in East Stroudsburg, PA
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.