Individual provider Active NPI

Angela D Zawisza, DO

  • Pediatrics Physician
  • Pottsville, PA
National Provider Identifier
1659538023
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OS015057 Issued in PA
Practice address
700 E Norwegian St
Pottsville, PA 17901-2710
Phone
(570) 621-4480
Fax
(570) 621-9213
NPI assigned
May 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X OT011947 PA
Pediatrics Physician 208000000X OS015057 PA Primary

Addresses

Primary practice location

700 E Norwegian St
Pottsville, PA 17901-2710

Mailing address

2100 Mack Blvd FL 4
Allentown, PA 18103-5622
Phone (570) 790-2391

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
I20100629000443 PA Practitioner - Pediatric Medicine 7719018100 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS015057PAMDPediatrics Physician
OT011947PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2025 Accepting new patients
Lehigh Valley Physician Group Pediatrics Current Accepting new patients
Schuylkill Health System Medical Group, Inc. CurrentSince Jun 13, 2017 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2025 Accepting new patients
Schuylkill Health System Medical Group, Inc. Pediatrics CurrentSince Jun 13, 2017 Accepting new patients
Lehigh Valley Hospital - Schuylkill Past Accepting new patients

Locations

2100 Mack Blvd
Fl 4
Allentown, PA 18103

205 E Laurel Blvd
Pottsville, PA 17901
Phone (570) 622-1887

420 S Jackson St
Pottsville, PA 17901
Phone (570) 621-5000

700 E Norwegian St
Pottsville, PA 17901
Phone (570) 621-4000

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240

Organizations & group practices 7

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": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1659538023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 4",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "570-790-2391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E NORWEGIAN ST",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179012710",
            "telephone_number": "570-621-4480",
            "fax_number": "570-621-9213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAWISZA",
        "first_name": "ANGELA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OT011947",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OS015057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pottsville, PA

Sources for this page

Verify at the official NPI Registry.