The Good Samaritan Hospital

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

072401 Issued in PA

Legal business name

THE GOOD SAMARITAN HOSPITAL

Practice address

Fourth and Walnut Streets
Lebanon, PA 17042

Phone

(717) 274-7580

Fax

(717) 228-0249

NPI assigned

Nov 3, 2006

Organization subpart

Yes

Parent organization

THE GOOD SAMARITAN HOSPITALAs reported in NPPES

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

Authorized official

Name

Robert J Richards

Title

VP Finance & Cfo

Phone

(717) 270-7806

Specialties & licenses 1

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• The Good Samaritan Hospital of Lebanon, Pennsylvania

  • Emergency Medicine Physician
  • Lebanon, PA
  • NPI 1730754284

  O20040420001427

  Same enrollment

Part of

Hyman S Caplan Pav GSH

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194912000000",
    "number": "1346329232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1281",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170421281",
            "telephone_number": "717-274-7580",
            "fax_number": "717-228-0249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FOURTH AND WALNUT STREETS",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "17042",
            "telephone_number": "717-274-7580",
            "fax_number": "717-228-0249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GOOD SAMARITAN HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE GOOD SAMARITAN HOSPITAL",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-11-13",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VP FINANCE & CFO",
        "authorized_official_telephone_number": "717-270-7806"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "072401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK FREEDOM BLUE",
            "identifier": "1373454",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "005267",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY MEDICARE ASSURED",
            "identifier": "1017455",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS 65(MEDIGAP CROSS OVER)",
            "identifier": "145461",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1373454",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STERLING OPTION 1",
            "identifier": "005267",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER GOLD",
            "identifier": "005267",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL WORK COMP",
            "identifier": "116415000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANTRA",
            "identifier": "005267",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA GOLD",
            "identifier": "005267",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul J. Teiken, M.D.
• Alexis Tellez-Hernandez, RD, LDN
• Rebecca J Testa, MSW
• Salma Tewfik, PHARMD
• The Good Samaritan Hospital
• The Good Samaritan Hospital
• The Good Samaritan Hospital
• The Good Samaritan Hospital
• The Good Samaritan Hospital of Lebanon, Pennsylvania
• The Good Samaritan Hospital of Lebanon, Pennsylvania

• Emergency Medicine Physician in Lebanon, PA
• Providers in Lebanon, PA by specialty
• Emergency Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.