Edward Thomas Stish Jr.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP036414 Issued in PA

Practice address

1711 E Broad St
Hazleton, PA 18201-5691

Phone

(570) 453-5100

NPI assigned

Jul 13, 2026

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1783900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1841119047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 CONYNGHAM DRUMS RD",
            "city": "SUGARLOAF",
            "state": "PA",
            "postal_code": "182493112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 E BROAD ST",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182015691",
            "telephone_number": "570-453-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STISH",
        "first_name": "EDWARD",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-07-13",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP036414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Steffes, DPT MTC NCTMB
• Thomas Jerard Stepanski
• Stephen M Wolk MD PC
• Stephen N. Shoemaker, D.O., P.C.
• Steven E. Nicholson, D.M.D., P.C.
• Heather Ann Sugarman, CRNP
• Surgical Specialists of Hazleton, P. C.
• Cassie Surplus, MA
• Kerry Swiech
• Lisa A Tabbit, DO

• Family Nurse Practitioner in Hazleton, PA
• Providers in Hazleton, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.