Individual provider Active NPI

John L. Holup, D.O.

  • Surgery Physician
  • Williamsport, PA
National Provider Identifier
1326010125
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
OS007311L Issued in PA
Practice address
1100 Grampian Blvd
Williamsport, PA 17701-1909
Phone
(570) 326-8550
NPI assigned
Feb 6, 2006
Last updated
Aug 9, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X OS007311L PA Primary

Addresses

Primary practice location

1100 Grampian Blvd
Williamsport, PA 17701-1909

Mailing address

1201 Grampian Blvd
Williamsport, PA 17701-1900
Phone (570) 326-8723

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 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

Enrollment IDStateProvider typePAC IDDetails
I20051220000231 NJ Practitioner - Family PracticePractitioner - General Surgery 2264416486 Reassigns benefits to 1 organization
I20070811000105 NY Practitioner - General SurgeryPractitioner - General Practice 2264416486 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS007311LPAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Marriott Medical Corp Surgery CurrentSince Jun 22, 2014 Accepting new patients
Middletown Medical PC CurrentSince Dec 15, 2012 Accepting new patients
Middletown Medical PC Surgery CurrentSince Dec 15, 2012 Accepting new patients
Bimc Faculty Practice Past Accepting new patients
Pascack Valley Surgical Association PA Surgery PastSince May 1, 2006 Accepting new patients

Locations

222 N Pacific Coast Hwy
Ste 1420
El Segundo, CA 90245

222 N Pacific Coast Hwy
Ste 2175
El Segundo, CA 90245
Phone (877) 850-8762

113 W Essex St
Ste 204
Maywood, NJ 07607
Phone (201) 289-5551

111 Maltese Dr
Middletown, NY 10940

Interoperability endpoints

  • Direct secure messaging: john.holup@direct.hvhc.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1326010125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900",
            "telephone_number": "570-326-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011909",
            "telephone_number": "570-326-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLUP",
        "first_name": "JOHN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "OS007311L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

Verify at the official NPI Registry.