Individual provider Active NPI

Stanislav Z Freydlin, PA-C

  • Physician Assistant
  • Lancaster, PA
National Provider Identifier
1376776401
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA056253 Issued in PA
Practice address
555 N Duke St
Lancaster, PA 17602-2250
Phone
(717) 299-4173
Fax
(717) 295-4773
NPI assigned
Aug 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0004027 MD
Physician Assistant 363A00000X MA056253 PA Primary

Addresses

Primary practice location

555 N Duke St
Lancaster, PA 17602-2250

Mailing address

PO Box 3555
Lancaster, PA 17604-3555
Phone (717) 299-4173

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140826002288 PA Practitioner - Physician Assistant 3072653716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lancaster Radiology Associates LTDGroup PAC ID 0648267526, 53 clinicians

Practice addresses (Care Compare)

2100 Harrisburg Pike
Lancaster, PA 17601-2644
Phone (717) 544-3104

2102 Harrisburg Pike
Lancaster, PA 17601-2644
Phone (717) 544-3113

540 N Duke St
Lancaster, PA 17602-2374
Phone (717) 544-2313

555 N Duke St
Lancaster, PA 17602-2250
Phone (717) 544-4900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0004027MDMDPhysician Assistant
MA056253PAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: sfreydlin168682@direct-lghealth.org

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1376776401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3555",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176043555",
            "telephone_number": "717-299-4173",
            "fax_number": "717-295-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 N DUKE ST",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176022250",
            "telephone_number": "717-299-4173",
            "fax_number": "717-295-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREYDLIN",
        "first_name": "STANISLAV",
        "middle_name": "Z",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-24",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0004027",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA056253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.