NPIMap

Individual provider Active NPI

Gregory A Formanek, M.D.

  • Hematology & Oncology Physician
  • East Stroudsburg, PA
National Provider Identifier
1568407583
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
MD041860L Issued in PA
Practice address
205 E Brown St
2ND Floor
East Stroudsburg, PA 18301-3006
Phone
(570) 420-2188
Fax
(570) 421-3493
NPI assigned
Jun 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 0101232517 VA
Hematology & Oncology Physician 207RH0003X MD041860L PA Primary

Addresses

Primary practice location

205 E Brown St
2ND Floor
East Stroudsburg, PA 18301-3006

Mailing address

PO Box 827658
Philadelphia, PA 19182-7658
Phone (570) 420-4951

Other identifiers 1

IdentifierTypeStateIssuer
C06778OtherVAGROUP PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140106000067 PA Practitioner - Medical Oncology 9436273778 Reassigns benefits to 1 organization
I20141023000852 NC Practitioner - Hematology/OncologyPractitioner - Internal Medicine 9436273778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
Rutgers New Jersey Medical School, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

1740 E Broad St
Hazleton, PA 18201-5667
Phone (570) 459-2901

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Jan 4, 2015 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Sep 15, 2014 Accepting new patients
Geisinger Clinic CurrentSince Jan 4, 2015 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation Hematology & Oncology CurrentSince Sep 15, 2014 Accepting new patients
Geisinger Clinic Current Accepting new patients
Virginia Physicians Inc Hematology & Oncology Past Accepting new patients
Bon Secours-St. Mary's Hospital of Richmond, Inc. Past Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

1200 N Elm St
#5
Greensboro, NC 27401
Phone (336) 832-5777

618 S Main St
Reidsville, NC 27320
Phone (336) 832-7965

100 N Academy Ave
Danville, PA 17822

1740 E Broad St
Hazleton, PA 18201
Phone (570) 459-2901

400 Highland Ave
Lewistown, PA 17044
Phone (717) 242-7473

Interoperability endpoints

  • Direct secure messaging: gformanek129289@direct.geisinger.edu
  • Direct secure messaging: gformanek@monvaleoncology.medentdirect.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 47

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374451200000",
    "number": "1568407583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 827658",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191827658",
            "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": "205 E BROWN ST",
            "address_2": "2ND FLOOR",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183013006",
            "telephone_number": "570-420-2188",
            "fax_number": "570-421-3493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMANEK",
        "first_name": "GREGORY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2013-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "VA",
            "license": "0101232517",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "PA",
            "license": "MD041860L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06778",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Stroudsburg, PA

Sources for this page

Verify at the official NPI Registry.