Active NPI
George J Chistakoff, PA-C
- Physician Assistant
- Reading, PA
National Provider Identifier
1740425099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA003540L
- Practice address
- 101 W Bern St
HSC BLDG 22
Reading, PA 19601 - Phone
- (610) 208-2276
- Fax
- (610) 208-2748
- NPI assigned
- Dec 15, 2008
- Last updated
- Jan 13, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA003540L | PA | Primary |
Addresses
Primary practice location
101 W Bern St
HSC BLDG 22
Reading, PA 19601
Mailing address
101 W Bern St
HSC BLDG 22
Reading, PA 19601
Phone (610) 208-2276
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA003540L | PA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231804800000",
"number": "1740425099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 W BERN ST",
"address_2": "HSC BLDG 22",
"city": "READING",
"state": "PA",
"postal_code": "19601",
"telephone_number": "610-208-2276",
"fax_number": "610-208-2748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W BERN ST",
"address_2": "HSC BLDG 22",
"city": "READING",
"state": "PA",
"postal_code": "19601",
"telephone_number": "610-208-2276",
"fax_number": "610-208-2748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHISTAKOFF",
"first_name": "GEORGE",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-12-15",
"last_updated": "2009-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA003540L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reading, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.