Individual provider Active NPI

Ramlah Mohyuddin Vahanvaty, MD

  • Pediatrics Physician
  • East Stroudsburg, PA
National Provider Identifier
1679527279
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD049684L Issued in PA
Practice address
419 King St
East Stroudsburg, PA 18301
Phone
(570) 424-8300
Fax
(570) 424-8301
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD049684L PA Primary

Addresses

Primary practice location

419 King St
East Stroudsburg, PA 18301

Mailing address

419 King St
East Stroudsburg, PA 18301
Phone (570) 424-8300

Other identifiers 1

IdentifierTypeStateIssuer
0014380690002MedicaidPA

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
I20230216000361 PA Practitioner - Psychiatry 0143692392 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

State licenses

LicenseStateTypeSpecialty
MD049684LPAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Physician Group, Inc. Current Accepting new patients
St Luke'S Physician Group Inc CurrentSince Nov 9, 2022 Accepting new patients
St. Luke'S Physician Group Inc. CurrentSince Nov 9, 2022 Accepting new patients
St. Luke'S Physician Group, Inc Past Accepting new patients

Locations

4311 Easton Ave
Bethlehem, PA 18020
Phone (610) 954-3600

125 Smithfield Ln
East Stroudsburg, PA 18301
Phone (272) 212-3872

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

208 Lifeline Rd
Ste 201
Stroudsburg, PA 18360
Phone (570) 476-6700

Interoperability endpoints

  • Direct secure messaging: ramlah.vahanvaty@slpg.direct-sluhn.org

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455753600000",
    "number": "1679527279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 KING ST",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "18301",
            "telephone_number": "570-424-8300",
            "fax_number": "570-424-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 KING ST",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "18301",
            "telephone_number": "570-424-8300",
            "fax_number": "570-424-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAHANVATY",
        "first_name": "RAMLAH",
        "middle_name": "MOHYUDDIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2016-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD049684L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014380690002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Stroudsburg, PA

Sources for this page

Verify at the official NPI Registry.