Individual provider Active NPI

Timothy De Ocejo, MD

  • Emergency Medicine Physician
  • Easton, PA
National Provider Identifier
1366186983
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD487813 Issued in PA
Practice address
1872 St Lukes Blvd
Easton, PA 18045-5669
Phone
(484) 526-1000
NPI assigned
Apr 21, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD487813 PA Primary

Addresses

Primary practice location

1872 St Lukes Blvd
Easton, PA 18045-5669

Mailing address

1700 St Lukes Blvd Ste 402
Easton, PA 18045-5670
Phone (484) 526-1000

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
I20250227003141 PA Practitioner - Emergency Medicine 2961899547 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Physician Group, Inc. Emergency Medicine CurrentSince Mar 1, 2025 Accepting new patients
Gslpg, Inc CurrentSince Mar 1, 2025 Accepting new patients
St. Luke'S Physician Group, Inc. Current Accepting new patients
St Luke'S Physician Group Inc CurrentSince Mar 1, 2025 Accepting new patients

Locations

1872 St Lukes Blvd
Easton, PA 18045
Phone (484) 503-1200

1700 St Lukes Blvd
Ste 402
Easton, PA 18045
Phone (301) 523-5990

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

100 Paramount Blvd
Orwigsburg, PA 17961
Phone (272) 639-1000

Organizations & group practices 4

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": "1650499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1366186983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 ST LUKES BLVD STE 402",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180455670",
            "telephone_number": "484-526-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1872 ST LUKES BLVD",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180455669",
            "telephone_number": "484-526-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE OCEJO",
        "first_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-21",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD487813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, PA

Sources for this page

Verify at the official NPI Registry.