Louis Patrick Degennaro, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD010124E Issued in PA

Practice address

940 Jefferson Ave
Scranton, PA 18510-1007

Phone

(570) 346-7900

Fax

(570) 963-5060

NPI assigned

Jul 28, 2005

Last updated

Apr 20, 2012By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northeast Ear, Nose & Throat Center, PC

  • Otolaryngology Physician
  • Scranton, PA
  • NPI 1427071323
  NPD (past) Authorized official

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334880000000",
    "number": "1861492266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 JEFFERSON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185101007",
            "telephone_number": "570-346-7900",
            "fax_number": "570-963-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 JEFFERSON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185101007",
            "telephone_number": "570-346-7900",
            "fax_number": "570-963-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGENNARO",
        "first_name": "LOUIS",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2012-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD010124E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009356960002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Decicco, PA-C
• Charles S Deck, M.D.
• Mary Louise Susan Decker, MD
• Champak M Dedhia, M.D.
• Christopher J Defrancesco, PHARMD., RPH
• Anthony Christopher Degrazia, DPT
• Bethany Dorothy Mary Degroat
• Mariah Deibert, PHARMD
• David Joshua Deisher, D.O.
• Stephanie Fleetwood Deivert, R.D.

• Specialist in Scranton, PA
• Providers in Scranton, PA by specialty
• Specialist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.