Jeffrey Pallas, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA000155L Issued in PA

Practice address

500 Plaza CT Ste B
East Stroudsburg, PA 18301-8262

Phone

(570) 517-2219

Fax

(570) 421-0862

NPI assigned

Apr 1, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1467624247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 E BROWN ST",
            "address_2": "POCONO HEALTHCARE MANAGEMENT",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183013006",
            "telephone_number": "570-420-4951",
            "fax_number": "570-476-3754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PLAZA CT STE B",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183018262",
            "telephone_number": "570-517-2219",
            "fax_number": "570-421-0862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLAS",
        "first_name": "JEFFREY",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-01",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA000155L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in East Stroudsburg, PA
• Providers in East Stroudsburg, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; 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.