NPIMap

Organization Active NPI

Maxime G Gedeon MD PC

  • Pain Medicine (Anesthesiology) Physician
  • Lehighton, PA
National Provider Identifier
1295799609
Registry record updated Dec 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
MAXIME G GEDEON MD PC
Practice address
1638 Blakeslee Boulevard Dr E
Lehighton, PA 18235-9623
Phone
(570) 386-4400
Fax
(570) 386-4050
NPI assigned
Apr 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2010

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

Authorized official

Name
Ms. Kimberly Bachman
Title
Billing Manager
Phone
(570) 386-3783

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

1638 Blakeslee Boulevard Dr E
Lehighton, PA 18235-9623

Mailing address

1638 Blakeslee Boulevard Dr E
Lehighton, PA 18235-9623
Phone (570) 386-4400

Other identifiers 1

IdentifierTypeStateIssuer
0015959640008MedicaidPA

Other names 1

  • ExcelCare Pain Mangement Center Doing business as

National Provider Directory

National Provider Directory

Locations

2851 W Emaus Ave
Allentown, PA 18103
Phone (215) 486-1800

1638 Blakeslee Boulevard Dr E
#D
Lehighton, PA 18235

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293408000000",
    "number": "1295799609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1638 BLAKESLEE BOULEVARD DR E",
            "city": "LEHIGHTON",
            "state": "PA",
            "postal_code": "182359623",
            "telephone_number": "570-386-4400",
            "fax_number": "570-386-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 BLAKESLEE BOULEVARD DR E",
            "city": "LEHIGHTON",
            "state": "PA",
            "postal_code": "182359623",
            "telephone_number": "570-386-4400",
            "fax_number": "570-386-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIME G GEDEON MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-13",
        "last_updated": "2010-12-27",
        "status": "A",
        "authorized_official_last_name": "BACHMAN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "570-386-3783",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015959640008",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ExcelCare Pain Mangement Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lehighton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2010; 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.