East Penn Rheumatology Associates, P.C.

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

MD012628E Issued in PA

Legal business name

EAST PENN RHEUMATOLOGY ASSOCIATES, P.C.

Practice address

701 Ostrum St Ste 302
Fountain Hill, PA 18015-1152

Phone

(610) 868-1336

Fax

(610) 882-1133

NPI assigned

Feb 2, 2007

Last updated

Jun 20, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Charles L. Ludivico, M.D.NPI 1750439147

Title

President

Phone

(610) 868-1336

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Tax ID family

East Penn Rheumatology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• East Penn Rheumatology

  • Rheumatology Physician
  • East Stroudsburg, PA
  • NPI 1952440844
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles L Ludivico, MD

  • Rheumatology Physician
  • Fountain Hill, PA
  • NPI 1750439147
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560988800000",
    "number": "1346388998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 OSTRUM ST STE 302",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180151152",
            "telephone_number": "610-868-1336",
            "fax_number": "610-882-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 OSTRUM ST STE 302",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180151152",
            "telephone_number": "610-868-1336",
            "fax_number": "610-882-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST PENN RHEUMATOLOGY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2019-06-20",
        "status": "A",
        "authorized_official_last_name": "LUDIVICO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-868-1336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "PA",
            "license": "MD012628E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellyn Gabrielle Dornseif, PA-C
• Fabio Lopes Dorville, M.D.
• Francis G Duhay, M.D.
• Omara Duran-Gates
• Jenny Duval, BA
• Edward C H Chen, M.D.
• Edward M Salgado MD PC
• Shaden Tonsi Eldakar-Hein, M.D.
• Empowerment Pathways
• Amy Esch, M.S., LPC

• Rheumatology Physician in Fountain Hill, PA
• Providers in Fountain Hill, PA by specialty
• Rheumatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; 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.