NPIMap

Organization Active NPI

Lancaster General Medical Group

Doing business as Lancaster Neurology Group

  • Neurology Physician
  • Lancaster, PA
National Provider Identifier
1871657684
Registry record updated Aug 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
LANCASTER GENERAL MEDICAL GROUP
Doing business as
Lancaster Neurology Group
Practice address
2106 Harrisburg Pike
Suite 310
Lancaster, PA 17601-2644
Phone
(717) 544-0545
Fax
(717) 544-0546
NPI assigned
Dec 19, 2006
Last updated
Aug 20, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2007

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

Authorized official

Name
Jerome I Gottlieb, M.D.
Title
President & Ceo
Phone
(717) 544-4001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X NU Primary

Addresses

Primary practice location

2106 Harrisburg Pike
Suite 310
Lancaster, PA 17601-2644

Mailing address

2106 Harrisburg Pike
Suite 310
Lancaster, PA 17601-2644
Phone (717) 544-0545

Other identifiers 7

IdentifierTypeStateIssuer
1472363OtherPAAETNA HMO
788VOtherPAGEISINGER HEALTH PLAN
1925949OtherPAHIGHMARK BLUE SHIELD
1007327490098MedicaidPA
1562801OtherPAGATEWAY HEALTH PLAN
50065485OtherPACAPITAL BLUE CROSS
7249870OtherPAAETNA NON-HMO

Other names 1

  • Lancaster Neurology Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040309000916 PA Part B Supplier - Clinic/Group Practice 0941103683 Receives reassigned benefits from 886 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187568000000",
    "number": "1871657684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 HARRISBURG PIKE",
            "address_2": "SUITE 310",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176012644",
            "telephone_number": "717-544-0545",
            "fax_number": "717-544-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 HARRISBURG PIKE",
            "address_2": "SUITE 310",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176012644",
            "telephone_number": "717-544-0545",
            "fax_number": "717-544-0546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANCASTER GENERAL MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-08-20",
        "status": "A",
        "authorized_official_last_name": "GOTTLIEB",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "717-544-4001",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "1472363",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PLAN",
            "identifier": "788V",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1925949",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007327490098",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HEALTH PLAN",
            "identifier": "1562801",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50065485",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NON-HMO",
            "identifier": "7249870",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lancaster Neurology Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lancaster, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; 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.