NPIMap

Individual provider Active NPI

Jeffrey Costanzo, MD

  • Gastroenterology Physician
  • East Stroudsburg, PA
National Provider Identifier
1689802746
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD454359 Issued in PA
Practice address
175 E Brown St
East Stroudsburg, PA 18301-3098
Phone
(570) 664-8115
NPI assigned
Jun 29, 2009
Last updated
Nov 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD454359 PA Primary

Addresses

Primary practice location

175 E Brown St
East Stroudsburg, PA 18301-3098

Mailing address

2100 Mack Blvd FL 4
Allentown, PA 18103-5622
Phone (610) 390-8057

Other practice location 1

2300 Highland Ave
Bethlehem, PA 18020-8920
Phone (610) 861-8080

Other practice location 2

1501 N Cedar Crest Blvd Ste 110
Allentown, PA 18104-2309
Phone (610) 821-2828

Other practice location 3

300 Lackawanna Ave Ste 200
Scranton, PA 18503-2001
Phone (570) 342-7864

Other identifiers 1

IdentifierTypeStateIssuer
103077684MedicaidPA

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL Stroudsburg Health Information Exchange (HIE) Family Care Centers Inc.
Direct Messaging Address jeffreycostanzo@epgi.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150624002701 PA Practitioner - Gastroenterology 5193036663 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

300 Lackawanna Ave
Suite 200
Scranton, PA 18503-2001
Phone (570) 342-7864

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy124
Upper gastrointestinal (GI) endoscopy for acid reflux144

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Pennsylvania Gastroenterology & Liver Specialists P C Gastroenterology CurrentSince Dec 31, 2020 Accepting new patients
DLP Conemaugh Physician Practices LLC Gastroenterology CurrentSince Feb 1, 2019 Accepting new patients
Lehigh Valley Physician Group CurrentSince Nov 1, 2022 Accepting new patients
Lehigh Valley Physician Group CurrentSince Nov 1, 2022 Accepting new patients
Family Care Centers Inc CurrentSince Dec 18, 2020 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Family Care Centers Inc. Current Accepting new patients
DLP Conemaugh Physician Practices LLC Current Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

1501 N Cedar Crest Blvd
Ste 110
Allentown, PA 18104
Phone (610) 821-2828

2100 Mack Blvd
Fl 4
Allentown, PA 18103

2300 Highland Ave
Bethlehem, PA 18020
Phone (610) 849-0691

2775 Schoenersville Rd
Bethlehem, PA 18017

175 E Brown St
East Stroudsburg, PA 18301
Phone (570) 421-3401

500 Plaza Ct
East Stroudsburg, PA 18301
Phone (570) 426-2330

500 Plaza Ct
Ste A
East Stroudsburg, PA 18301
Phone (570) 424-9970

3701 Corriere Rd
Ste 17
Easton, PA 18045
Phone (610) 821-2828

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

300 Lackawanna Ave
Ste 200
Scranton, PA 18503
Phone (570) 342-7864

Interoperability endpoints

  • Direct secure messaging: jcostanzo118533@direct2.lvhn.org

Organizations & group practices 10

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 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1689802746",
    "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": "610-390-8057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E BROWN ST",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183013098",
            "telephone_number": "570-664-8115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180208920",
            "country_code": "US",
            "telephone_number": "610-861-8080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1501 N Cedar Crest Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181042309",
            "country_code": "US",
            "telephone_number": "610-821-2828",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Lackawanna Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Scranton",
            "state": "PA",
            "postal_code": "185032001",
            "country_code": "US",
            "telephone_number": "570-342-7864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSTANZO",
        "first_name": "JEFFREY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-29",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD454359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103077684",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Stroudsburg",
            "affiliation": "Y",
            "affiliationName": "Family Care Centers Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EPIC",
            "address_1": "175 E Brown St",
            "city": "East Stroudsburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "183013098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeffreycostanzo@epgi.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1501 N Cedar Crest Blvd Ste 110",
            "city": "Allentown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "181042309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in East Stroudsburg, PA

Sources for this page

Verify at the official NPI Registry.