Individual provider Active NPI

Edward William Milisits III, DPT

  • Physical Therapist
  • Stroudsburg, PA
National Provider Identifier
1346836483
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT029051 Issued in PA
Practice address
208 Lifeline Rd Ste 104
Stroudsburg, PA 18360-6473
Phone
(570) 664-8780
NPI assigned
Dec 14, 2020
Last updated
Dec 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT029051 PA Primary

Addresses

Primary practice location

208 Lifeline Rd Ste 104
Stroudsburg, PA 18360-6473

Mailing address

3247 Beaufort Dr
Bethlehem, PA 18017-1955
Phone (610) 462-8597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT029051PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Hospital - Anderson Campus PastSince Dec 16, 2020 Accepting new patients
St. Luke's Hospital Monroe Campus PastSince Dec 16, 2020 Accepting new patients

Organizations & group practices 2

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": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1346836483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3247 BEAUFORT DR",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180171955",
            "telephone_number": "610-462-8597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 LIFELINE RD STE 104",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183606473",
            "telephone_number": "570-664-8780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILISITS",
        "first_name": "EDWARD",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT029051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stroudsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; 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.