NPIMap

Organization Active NPI

Pediatric Practices of Northeastern PA

  • Pediatrics Physician
  • Milford, PA
National Provider Identifier
1861722902
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC PRACTICES OF NORTHEASTERN PA
Practice address
510 Route 6 and 209
Suite 103
Milford, PA 18337-7615
Phone
(570) 296-4901
Fax
(570) 253-1245
NPI assigned
Jan 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

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

Authorized official

Name
Dr. Robert Morton, MDNPI 1780667097
Title
Partner
Phone
(570) 253-5838

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

510 Route 6 and 209
Suite 103
Milford, PA 18337-7615

Mailing address

1837 Fair Ave
Honesdale, PA 18431
Phone (570) 296-4901

Other identifiers 2

IdentifierTypeStateIssuer
1007422260004MedicaidPA
1007422260010MedicaidPA

Other names 1

  • Pediatric Practices of Northeastern PA Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Practices of Northeastern PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

510 Route 6 and 209
Ste 103
Milford, PA 18337
Phone (570) 296-4901

Practitioners & affiliated clinicians

Practitioners 9

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": "1263340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433116800000",
    "number": "1861722902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1837 FAIR AVE",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "18431",
            "telephone_number": "570-296-4901",
            "fax_number": "570-296-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 ROUTE 6 AND 209",
            "address_2": "SUITE 103",
            "city": "MILFORD",
            "state": "PA",
            "postal_code": "183377615",
            "telephone_number": "570-296-4901",
            "fax_number": "570-253-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PRACTICES OF NORTHEASTERN PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-13",
        "last_updated": "2015-06-01",
        "status": "A",
        "authorized_official_last_name": "MORTON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "570-253-5838",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007422260004",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007422260010",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Practices of Northeastern PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; 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.