Active NPI
Paul Gerard Marcincin, M.D.
- Specialist
- Bethlehem, PA
National Provider Identifier
1386639698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MD040755E
- Practice address
- 2597 Schoenersville Rd
Suite 303
Bethlehem, PA 18017-7325 - Phone
- (610) 861-7727
- Fax
- (610) 861-2995
- NPI assigned
- Sep 13, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MD040755E | PA | Primary |
Addresses
Primary practice location
2597 Schoenersville Rd
Suite 303
Bethlehem, PA 18017-7325
Mailing address
2597 Schoenersville Rd
Suite 303
Bethlehem, PA 18017-7325
Phone (610) 861-7727
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 55701 | Other | AETNA ID NUMBER | |
| 515265 | Other | HIGMARK BLUE SHIELD | |
| 01033101 | Other | CAPITOL BLUE CROSS | |
| 990714 | Other | PA | KEYSTONE CENTRAL ID |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD040755E | PA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Warren Skin Care Center PA | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
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- Phillipsburg, NJ
- NPI 1669587267
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286323200000",
"number": "1386639698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2597 SCHOENERSVILLE RD",
"address_2": "SUITE 303",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180177325",
"telephone_number": "610-861-7727",
"fax_number": "610-861-2995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2597 SCHOENERSVILLE RD",
"address_2": "SUITE 303",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180177325",
"telephone_number": "610-861-7727",
"fax_number": "610-861-2995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCINCIN",
"first_name": "PAUL",
"middle_name": "GERARD",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-13",
"last_updated": "2010-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "PA",
"license": "MD040755E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA ID NUMBER",
"identifier": "55701",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGMARK BLUE SHIELD",
"identifier": "515265",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITOL BLUE CROSS",
"identifier": "01033101",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE CENTRAL ID",
"identifier": "990714",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bethlehem, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.