Organization Active NPI

Cosmetic and Plastic Surgery of Central Pennsylvania, LLC

  • Plastic Surgery Physician
  • Camp Hill, PA
National Provider Identifier
1851794283
Registry record updated Nov 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MD438302 Issued in PA
Legal business name
COSMETIC AND PLASTIC SURGERY OF CENTRAL PENNSYLVANIA, LLC
Practice address
425 N 21St St
Suite 405
Camp Hill, PA 17011-2223
Phone
(717) 695-6553
Fax
(855) 383-3233
NPI assigned
Sep 30, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2014

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

Authorized official

Name
Dr. Theodore T Foley, M.D.NPI 1225242696
Title
Plastic Surgeon/Member, Sole Owner
Phone
(717) 873-1526

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X MD438302 PA Primary

Addresses

Primary practice location

425 N 21St St
Suite 405
Camp Hill, PA 17011-2223

Mailing address

425 N 21St St
Suite 405
Camp Hill, PA 17011-2223
Phone (717) 695-6553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150107001441 PA Part B Supplier - Clinic/Group Practice 0941523542 Receives reassigned benefits from 1 practitioner
Practice locations: Camp Hill, PA; Carlisle, PA; Enola, PA; Mechanicsburg, PA

National Provider Directory

National Provider Directory

Locations

503 N 21st St
#A
Camp Hill, PA 17011
Phone (717) 763-2100

425 N 21st St
Ste 405
Camp Hill, PA 17011
Phone (717) 695-6553

31 Sprint Dr
Carlisle, PA 17015
Phone (717) 960-3700

4300 Londonderry Rd
#M
Harrisburg, PA 17109
Phone (717) 727-6740

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416787200000",
    "number": "1851794283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 N 21ST ST",
            "address_2": "SUITE 405",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170112223",
            "telephone_number": "717-695-6553",
            "fax_number": "855-383-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N 21ST ST",
            "address_2": "SUITE 405",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170112223",
            "telephone_number": "717-695-6553",
            "fax_number": "855-383-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSMETIC AND PLASTIC SURGERY OF CENTRAL PENNSYLVANIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-30",
        "last_updated": "2014-11-24",
        "status": "A",
        "authorized_official_last_name": "FOLEY",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PLASTIC SURGEON/MEMBER, SOLE OWNER",
        "authorized_official_telephone_number": "717-873-1526",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "PA",
            "license": "MD438302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Hill, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.