Individual provider Active NPI

Timothy John Prestosh, D.O.

  • Family Medicine Physician
  • Allentown, PA
National Provider Identifier
1295927341
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS014052 Issued in PA
Practice address
1501 Lehigh St
Allentown, PA 18103-3880
Phone
(610) 628-8380
NPI assigned
Aug 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS014052 PA Primary

Addresses

Primary practice location

1501 Lehigh St
Allentown, PA 18103-3880

Mailing address

3025 Shakespeare Rd
Bethlehem, PA 18017-3219

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
I20090327000398 PA Practitioner - Family Practice 3274690763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Patient First Pennsylvania Medical Group PLLCGroup PAC ID 5193900280, 132 clinicians

Practice addresses (Care Compare)

5125 Jonestown Rd
Suite 105
Harrisburg, PA 17112-2987
Phone (717) 943-1566

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS014052PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Patient First Pennsylvania Medical Group PLLC Family Medicine CurrentSince Feb 6, 2020 Accepting new patients
Patient First Pennsylvania Medical Group PLLC Family Medicine CurrentSince Feb 6, 2020 Accepting new patients
Premier Immediate Medical Care, LLC Past Accepting new patients

Locations

5125 Jonestown Rd
Ste 105
Harrisburg, PA 17112
Phone (717) 943-1566

713 Bethlehem Pike
Montgomeryvle, PA 18936
Phone (267) 695-3944

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

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.

NPI Registry JSON

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1295927341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 SHAKESPEARE RD",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180173219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 LEHIGH ST",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181033880",
            "telephone_number": "610-628-8380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTOSH",
        "first_name": "TIMOTHY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-13",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS014052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.