NPIMap

Organization Active NPI

Jefferson Surgical Associates, PC

  • Surgery Physician
  • Punxsutawney, PA
National Provider Identifier
1891809117
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD044264L Issued in PA
Legal business name
JEFFERSON SURGICAL ASSOCIATES, PC
Practice address
81 Hillcrest Dr
Suite 2600
Punxsutawney, PA 15767-2605
Phone
(814) 938-4121
Fax
(814) 938-4158
NPI assigned
Aug 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kyle Andrew Lingenfelter, MD
Title
President
Phone
(814) 938-4121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X MD044264L PA Primary

Addresses

Primary practice location

81 Hillcrest Dr
Suite 2600
Punxsutawney, PA 15767-2605

Mailing address

81 Hillcrest Dr
Suite 2600
Punxsutawney, PA 15767-2605
Phone (814) 938-4121

Other identifiers 1

IdentifierTypeStateIssuer
0014589380002MedicaidPA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891809117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 HILLCREST DR",
            "address_2": "SUITE 2600",
            "city": "PUNXSUTAWNEY",
            "state": "PA",
            "postal_code": "157672605",
            "telephone_number": "814-938-4121",
            "fax_number": "814-938-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 HILLCREST DR",
            "address_2": "SUITE 2600",
            "city": "PUNXSUTAWNEY",
            "state": "PA",
            "postal_code": "157672605",
            "telephone_number": "814-938-4121",
            "fax_number": "814-938-4158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON SURGICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LINGENFELTER",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-938-4121",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD044264L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014589380002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Punxsutawney, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.