Active NPI
Joseph Putprush, MD
- Clinical Pathology/Laboratory Medicine Physician
- Wilkes Barre, PA
National Provider Identifier
1750346029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Pathology/Laboratory Medicine Physician
- License
- MD019559E
- Practice address
- 575 N River St
Wilkes Barre, PA 18764-0999 - Phone
- (570) 829-8111
- NPI assigned
- Apr 19, 2006
- 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 |
|---|---|---|---|---|
| Clinical Pathology/Laboratory Medicine Physician | 207ZP0105X | MD019559E | PA | Primary |
Addresses
Primary practice location
575 N River St
Wilkes Barre, PA 18764-0999
Mailing address
PO Box 1476
Kingston, PA 18704-0476
Phone (570) 714-5525
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0009443270006 | Medicaid | PA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211414400000",
"number": "1750346029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1476",
"city": "KINGSTON",
"state": "PA",
"postal_code": "187040476",
"telephone_number": "570-714-5525",
"fax_number": "570-714-5548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "575 N RIVER ST",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "187640999",
"telephone_number": "570-829-8111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUTPRUSH",
"first_name": "JOSEPH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-19",
"last_updated": "2008-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0105X",
"taxonomy_group": "",
"desc": "Pathology, Clinical Pathology/Laboratory Medicine",
"state": "PA",
"license": "MD019559E",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0009443270006",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilkes Barre, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.