Organization Active NPI

Eaglesmere Medical Associates,PC

  • Internal Medicine Physician
  • East Stroudsburg, PA
National Provider Identifier
1578744272
Registry record updated Nov 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
EAGLESMERE MEDICAL ASSOCIATES,PC
Practice address
100 Eaglesmere Cir Ste a
East Stroudsburg, PA 18301-3144
Phone
(570) 421-4331
NPI assigned
Nov 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2007

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

Authorized official

Name
Mrs. Iwona A Koscielniak
Title
Office Manager
Phone
(570) 421-4331

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

100 Eaglesmere Cir Ste a
East Stroudsburg, PA 18301-3144

Mailing address

100 Eaglesmere Cir Ste a
East Stroudsburg, PA 18301-3144
Phone (570) 421-4331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080212000382 PA Part B Supplier - Clinic/Group Practice 1951484195 Receives reassigned benefits from 1 practitioner
Practice locations: East Stroudsburg, PA

National Provider Directory

National Provider Directory

Locations

100 Eaglesmere Cir
Ste A
East Stroudsburg, PA 18301
Phone (570) 421-4331

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195603200000",
    "number": "1578744272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 EAGLESMERE CIR STE A",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183013144",
            "telephone_number": "570-421-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EAGLESMERE CIR STE A",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183013144",
            "telephone_number": "570-421-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLESMERE MEDICAL ASSOCIATES,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-21",
        "last_updated": "2007-11-21",
        "status": "A",
        "authorized_official_last_name": "KOSCIELNIAK",
        "authorized_official_first_name": "IWONA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "570-421-4331",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Stroudsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.