NPIMap

Organization Active NPI

Main Line Gastroenterology Associates, PC

  • Gastroenterology Physician
  • Malvern, PA
National Provider Identifier
1467429365
Registry record updated Aug 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
MAIN LINE GASTROENTEROLOGY ASSOCIATES, PC
Practice address
325 Central Ave
2ND Floor
Malvern, PA 19355-3265
Phone
(610) 644-6755
Fax
(610) 647-2063
NPI assigned
Mar 1, 2006
Last updated
Aug 5, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2009

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

Authorized official

Name
Dr. Keith J. Laskin, M.D.
Title
Secretary
Phone
(610) 644-6755

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X Primary

Addresses

Primary practice location

325 Central Ave
2ND Floor
Malvern, PA 19355-3265

Mailing address

PO Box 350
Sellersville, PA 18960-0350
Phone (215) 723-2333

Other identifiers 2

IdentifierTypeStateIssuer
0015085480009MedicaidPA
CA1051OtherPARAILROAD

National Provider Directory

National Provider Directory

Locations

1 Medical Center Blvd
Bldg 11
Chester, PA 19013

707 Eagleview Blvd
Ste 100
Exton, PA 19341

325 Central Ave
Fl 2
Malvern, PA 19355

325 Central Ave
Ste 200
Malvern, PA 19355

100 E Lancaster Ave
Ste 252
Wynnewood, PA 19096
Phone (610) 896-7360

Practitioners & affiliated clinicians

Practitioners 104

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 104

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249430400000",
    "number": "1467429365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 350",
            "city": "SELLERSVILLE",
            "state": "PA",
            "postal_code": "189600350",
            "telephone_number": "215-723-2333",
            "fax_number": "215-723-9112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 CENTRAL AVE",
            "address_2": "2ND FLOOR",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193553265",
            "telephone_number": "610-644-6755",
            "fax_number": "610-647-2063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN LINE GASTROENTEROLOGY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-01",
        "last_updated": "2009-08-05",
        "status": "A",
        "authorized_official_last_name": "LASKIN",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "610-644-6755",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015085480009",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "CA1051",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Malvern, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2009; 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.