Active NPI
Antonio Panebianco, MD
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Macungie, PA
National Provider Identifier
1447243787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- MD028954L
- Practice address
- 2560 Mill Creek Rd
Macungie, PA 18062-8824 - Phone
- (484) 221-3717
- Fax
- (610) 351-1158
- NPI assigned
- Aug 23, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | MD028954L | PA | Primary |
Addresses
Primary practice location
2560 Mill Creek Rd
Macungie, PA 18062-8824
Mailing address
2560 Mill Creek Rd
Macungie, PA 18062-8824
Phone (484) 221-3717
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0040153000 | Other | PA | INDEPENDENCE BLUE CROSS |
| 017216 | Other | PA | HIGHMARK PIN |
| 50026859 | Other | PA | CAPITAL BLUE CROSS |
| 0006407420003 | Medicaid | PA | |
| 0006407420004 | Medicaid | PA |
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 |
|---|---|---|---|
| MD028954L | PA | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362009600000",
"number": "1447243787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2560 MILL CREEK RD",
"city": "MACUNGIE",
"state": "PA",
"postal_code": "180628824",
"telephone_number": "484-221-3717",
"fax_number": "610-351-1158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2560 MILL CREEK RD",
"city": "MACUNGIE",
"state": "PA",
"postal_code": "180628824",
"telephone_number": "484-221-3717",
"fax_number": "610-351-1158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANEBIANCO",
"first_name": "ANTONIO",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-23",
"last_updated": "2013-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "PA",
"license": "MD028954L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENCE BLUE CROSS",
"identifier": "0040153000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK PIN",
"identifier": "017216",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "50026859",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0006407420003",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0006407420004",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Macungie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.