NPIMap

Individual provider Active NPI

Eugene R. Stish, MD

  • Family Medicine Physician
  • West Hazleton, PA
National Provider Identifier
1891746962
Registry record updated Mar 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD037411E Issued in PA
Practice address
600 Penn St
West Hazleton, PA 18202-1514
Phone
(570) 497-4940
Fax
(570) 497-4942
NPI assigned
May 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD037411E PA Primary

Addresses

Primary practice location

600 Penn St
West Hazleton, PA 18202-1514

Mailing address

PO Box 1388
Kingston, PA 18704-0388
Phone (570) 288-8881

Other identifiers 6

IdentifierTypeStateIssuer
182834OtherCAPITAL ADVANTAGE
710941282OtherHEALTH AMERICA
002708OtherFIRST PRIORITY HEALTH
182834OtherPAPA BLUE SHIELD
710941282OtherCHAMPUS
710941282OtherAMERIHEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041207000135 PA Practitioner - Family Practice 2961486741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Temple University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

600 Penn St
West Hazleton, PA 18202-1514
Phone (570) 497-4940

Hospital & facility affiliations

  • Maylath Valley Health Systems, Inc. Home health agency, Sybertsville, PA, CCN 398041
  • All Care Home Care, Inc Home health agency, Hazleton, PA, CCN 397449
  • Lehigh Valley Hospital - Hazleton Hospital, Hazleton, PA, CCN 390185
  • Geisinger Medical Center Hospital, Danville, PA, CCN 390006
  • St Luke'S Miners Memorial Hospital Hospital, Coaldale, PA, CCN 390183
  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133
  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Stish Family Practice PC Family Medicine CurrentSince Apr 10, 2003 Accepting new patients

Organizations & group practices 1

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.

Hospital & facility affiliations 55

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 55

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490572800000",
    "number": "1891746962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1388",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187040388",
            "telephone_number": "570-288-8881",
            "fax_number": "570-288-8065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PENN ST",
            "city": "WEST HAZLETON",
            "state": "PA",
            "postal_code": "182021514",
            "telephone_number": "570-497-4940",
            "fax_number": "570-497-4942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STISH",
        "first_name": "EUGENE",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2017-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD037411E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL ADVANTAGE",
            "identifier": "182834",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA",
            "identifier": "710941282",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH",
            "identifier": "002708",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BLUE SHIELD",
            "identifier": "182834",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "710941282",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "710941282",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hazleton, PA

Sources for this page

Verify at the official NPI Registry.