Active NPI
Walter E Pae Jr., MD
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Hershey, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- MD021710E
- Practice address
- 500 University Dr
Hershey, PA 17033-2360 - Phone
- (800) 233-4082
- NPI assigned
- May 3, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | MD021710E | PA | Primary |
| Surgery Physician | 208600000X | MD021710E | PA |
Addresses
Primary practice location
500 University Dr
Hershey, PA 17033-2360
Mailing address
PO Box 854
MC A410
Hershey, PA 17033-0854
Phone (800) 233-4082
Other practice location 1
25 Monument Rd Ste 190
York, PA 17403-5059
Phone (717) 851-6454
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0008075510001 | Medicaid | PA |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD021710E | PA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellspan Medical Group | Current | Accepting new patients | |
| The Milton S Hershey Medical Center Physician Group | Current | Accepting new patients | |
| The Milton S Hershey Medical Center - Physicians Group | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Current | Accepting new patients |
| Wellspan Medical Group | Current | Accepting new patients | |
| The Milton S Hershey Medical Center Physicians Group | Current | Accepting new patients | |
| Wellspan Medical Group | Current | Accepting new patients |
Locations
500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131
500 University Dr
Hershey, PA 17033
Phone (717) 531-8181
25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250
25 Monument Rd
Ste 190
York, PA 17403
Phone (717) 741-8011
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Hershey, PA
- NPI 1710951744
-
- Gastroenterology Physician
- York, PA
- NPI 1669770004
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Hershey, PA
- NPI 1457325474
-
- Body Imaging Physician
- Hershey, PA
- NPI 1346215928
-
- Pediatric Surgery Physician
- York, PA
- NPI 1104799428
-
- Family Medicine Physician
- York, PA
- NPI 1457044794
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1841258522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 854",
"address_2": "MC A410",
"city": "HERSHEY",
"state": "PA",
"postal_code": "170330854",
"telephone_number": "800-233-4082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 UNIVERSITY DR",
"city": "HERSHEY",
"state": "PA",
"postal_code": "170332360",
"telephone_number": "800-233-4082"
}
],
"practiceLocations": [
{
"address_1": "25 Monument Rd Ste 190",
"address_purpose": "LOCATION",
"city": "York",
"state": "PA",
"postal_code": "174035059",
"country_code": "US",
"telephone_number": "717-851-6454",
"fax_number": "717-851-1665",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PAE",
"first_name": "WALTER",
"middle_name": "E",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-03",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "PA",
"license": "MD021710E",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "PA",
"license": "MD021710E",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0008075510001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hershey, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.