Individual provider Active NPI

Stefan J Antosiewicz, MD

  • Diagnostic Radiology Physician
  • Allentown, PA
National Provider Identifier
1710470315
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MT236019 Issued in PA
Practice address
1200 S Cedar Crest Blvd Ste 203
Allentown, PA 18103-6202
Phone
(610) 402-1033
NPI assigned
Jun 8, 2018
Last updated
Apr 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MT236019 PA Primary

Addresses

Primary practice location

1200 S Cedar Crest Blvd Ste 203
Allentown, PA 18103-6202

Mailing address

64 Lafayette St Apt 1
Jersey City, NJ 07304-7002
Phone (732) 586-7354

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
I20260504006627 PA Order and Referring Only - Diagnostic RadiologyPractitioner - Diagnostic Radiology 3375011828

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT236019PAMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1528416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1710470315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 LAFAYETTE ST APT 1",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073047002",
            "telephone_number": "732-586-7354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S CEDAR CREST BLVD STE 203",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036202",
            "telephone_number": "610-402-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTOSIEWICZ",
        "first_name": "STEFAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-08",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MT236019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.