Individual provider Active NPI

Peter Favini, MD

  • Emergency Medicine Physician
  • Easton, PA
National Provider Identifier
1629024708
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD031795E Issued in PA
Practice address
1872 Riverside Cir
Easton, PA 18045-5669
Phone
(484) 503-1200
Fax
(484) 503-1206
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD031795E PA Primary

Addresses

Primary practice location

1872 Riverside Cir
Easton, PA 18045-5669

Mailing address

1872 Riverside Cir
Easton, PA 18045-5669
Phone (484) 503-1200

Other identifiers 3

IdentifierTypeStateIssuer
000963690003MedicaidPA
930092699OtherPARAILROAD MEDICARE
FA108883OtherPABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040525000979 PA Practitioner - Emergency Medicine 3375445851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Physician Group, Inc. Current Accepting new patients
St Luke'S Physician Group Inc CurrentSince Aug 1, 2013 Accepting new patients
St. Luke'S Physician Group, Inc. CurrentSince Aug 1, 2013 Accepting new patients
Pocono Emergency Physicians, P.C. Emergency Medicine PastSince Jan 24, 2004 Accepting new patients

Locations

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403740800000",
    "number": "1629024708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1872 RIVERSIDE CIR",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180455669",
            "telephone_number": "484-503-1200",
            "fax_number": "484-503-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1872 RIVERSIDE CIR",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180455669",
            "telephone_number": "484-503-1200",
            "fax_number": "484-503-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVINI",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2014-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD031795E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000963690003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930092699",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "FA108883",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, PA

Sources for this page

Verify at the official NPI Registry.