Individual provider Active NPI

James G Waxmonsky, MD

  • Psychiatry Physician
  • Hershey, PA
National Provider Identifier
1659469278
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD448664 Issued in PA
Practice address
22 Northeast Dr
Hershey, PA 17033-2732
Phone
(717) 531-8338
Fax
(717) 531-6250
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD448664 PA Primary

Addresses

Primary practice location

22 Northeast Dr
Hershey, PA 17033-2732

Mailing address

PO Box 858
Hershey, PA 17033-0858
Phone (800) 243-1455

Other identifiers 2

IdentifierTypeStateIssuer
1028509010001MedicaidPA
315739OtherPAMEDICARE

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
I20131028001380 PA Practitioner - Psychiatry 8628203676 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pennsylvania Psychiatric Institute CurrentSince Jul 15, 2013 Accepting new patients
The Milton S Hershey Medical Center Physician Group CurrentSince Jul 15, 2013 Accepting new patients
Pennsylvania Psychiatric Institute CurrentSince Jul 15, 2013 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Psychiatry CurrentSince Jul 15, 2013 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients

Locations

2501 N 3rd St
Harrisburg, PA 17110
Phone (717) 782-2100

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

Organizations & group practices 5

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519344000000",
    "number": "1659469278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 858",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330858",
            "telephone_number": "800-243-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 NORTHEAST DR",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332732",
            "telephone_number": "717-531-8338",
            "fax_number": "717-531-6250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAXMONSKY",
        "first_name": "JAMES",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2018-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD448664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1028509010001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "315739",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hershey, PA

Sources for this page

Verify at the official NPI Registry.