Alfred Konopka Bachiller, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS019620 Issued in PA

Practice address

1705 Warren Ave, 303
Williamsport, PA 17701-2665

Phone

(570) 326-8500

Fax

(570) 326-8049

NPI assigned

Aug 28, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1440720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545264000000",
    "number": "1487021127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1264 SNYDER AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185043186",
            "telephone_number": "570-903-0551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 WARREN AVE, 303",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177012665",
            "telephone_number": "570-326-8500",
            "fax_number": "570-326-8049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "621 Tenth Street",
            "address_purpose": "LOCATION",
            "city": "Niagara Falls",
            "state": "NY",
            "postal_code": "14302",
            "country_code": "US",
            "telephone_number": "570-903-0551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACHILLER",
        "first_name": "ALFRED",
        "middle_name": "KONOPKA",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-28",
        "last_updated": "2018-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS019620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Williamsport, PA
• Providers in Williamsport, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.