NPIMap

Individual provider Active NPI

Peter Phillips, MD

  • Clinical Pathology/Laboratory Medicine Physician
  • Lebanon, PA
National Provider Identifier
1467431015
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
License
MD045723L Issued in PA
Practice address
4TH and Walnut St
Lebanon, PA 17042
Phone
(610) 568-1380
NPI assigned
Jan 12, 2006
Last updated
Apr 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X MD045723L PA Primary

Addresses

Primary practice location

4TH and Walnut St
Lebanon, PA 17042

Mailing address

2 Meridian Blvd
2ND Floor
Wyomissing, PA 19610-3202
Phone (610) 568-1380

Other practice location 1

169 Martin Ave
Ephrata, PA 17522-1734
Phone (717) 721-4740

Other practice location 2

37 N 5th St
Gettysburg, PA 17325-2004
Phone (717) 339-3125

Other identifiers 1

IdentifierTypeStateIssuer
0014733260001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100726000062 PA Practitioner - Pathology 6103958251 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Pennsylvania State University College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ephrata Community HospitalGroup PAC ID 4981514445, shared by 7 NPIs, 35 clinicians

Practice addresses (Care Compare)

169 Martin Ave
Ephrata, PA 17522-1734
Phone (717) 733-0311

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD045723LPAMDClinical Pathology/Laboratory Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ephrata Community Hospital CurrentSince Oct 2, 2023 Accepting new patients
Ephrata Community Hospital CurrentSince Oct 2, 2023 Accepting new patients
Ephrata Community Hospital Clinical Pathology/Laboratory Medicine CurrentSince Jan 9, 2024 Accepting new patients

Locations

169 Martin Ave
Ephrata, PA 17522
Phone (717) 733-0311

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

Organizations & group practices 3

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.

Hospital & facility affiliations 8

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": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1467431015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MERIDIAN BLVD",
            "address_2": "2ND FLOOR",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103202",
            "telephone_number": "610-568-1380",
            "fax_number": "610-372-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4TH AND WALNUT ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "17042",
            "telephone_number": "610-568-1380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Martin Ave",
            "address_purpose": "LOCATION",
            "city": "Ephrata",
            "state": "PA",
            "postal_code": "175221734",
            "country_code": "US",
            "telephone_number": "717-721-4740",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "37 N 5th St",
            "address_purpose": "LOCATION",
            "city": "Gettysburg",
            "state": "PA",
            "postal_code": "173252004",
            "country_code": "US",
            "telephone_number": "717-339-3125",
            "fax_number": "717-334-3184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "PA",
            "license": "MD045723L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014733260001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.