NPIMap

Individual provider Active NPI

Lisa Pathak, M.D.

  • Internal Medicine Physician
  • Dingmans Ferry, PA
National Provider Identifier
1609868314
Registry record updated Mar 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD423073 Issued in PA
Practice address
1592 Route 739
Dingmans Ferry, PA 18328-3477
Phone
(570) 828-8000
Fax
(570) 828-6928
NPI assigned
Aug 18, 2005
Last updated
Mar 11, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD423073 PA Primary
Pediatrics Physician 208000000X MD423073 PA

Addresses

Primary practice location

1592 Route 739
Dingmans Ferry, PA 18328-3477

Mailing address

1592 Route 739
Dingmans Ferry, PA 18328-3477
Phone (570) 828-8000

Other identifiers 1

IdentifierTypeStateIssuer
0019656260004MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 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
I20031209000432 PA Practitioner - Internal MedicinePractitioner - Pediatric Medicine 5496651754 Reassigns benefits to 1 organization
I20040318000393 NY Practitioner - Internal MedicinePractitioner - Pediatric Medicine 5496651754

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Icahn School of Medicine at Mount Sinai, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1592 Route 739
Dingmans Ferry, PA 18328-3513
Phone (570) 828-8000

1592 Route 739
Suite 1
Dingmans Ferry, PA 18328-0001

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Medical Center, Inc CurrentSince Jun 28, 2023 Accepting new patients
Lisa Pathak MD LLC CurrentSince Jul 15, 2009 Accepting new patients
Bon Secours Community Hospital Internal Medicine Past Accepting new patients
Lehigh Valley Hospital Pocono Past Accepting new patients

Locations

14 Jason Pl
Ste 201
Middletown, NY 10940
Phone (845) 513-6616

1592 Route 739
Dingmans Fry, PA 18328
Phone (570) 828-1900

1592 Route 739
Ste 1
Dingmans Fry, PA 18328
Phone (570) 828-8000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HCIJCD

Organizations & group practices 4

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236729600000",
    "number": "1609868314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1592 ROUTE 739",
            "city": "DINGMANS FERRY",
            "state": "PA",
            "postal_code": "183283477",
            "telephone_number": "570-828-8000",
            "fax_number": "570-828-6928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1592 ROUTE 739",
            "city": "DINGMANS FERRY",
            "state": "PA",
            "postal_code": "183283477",
            "telephone_number": "570-828-8000",
            "fax_number": "570-828-6928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATHAK",
        "first_name": "LISA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2009-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD423073",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD423073",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019656260004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dingmans Ferry, PA

Sources for this page

Verify at the official NPI Registry.