Organization Active NPI

Pocono Pediatric Associates, Inc

  • Pediatrics Physician
  • Stroudsburg, PA
National Provider Identifier
1932194446
Registry record updated May 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
POCONO PEDIATRIC ASSOCIATES, INC
Practice address
208 Lifeline Rd
Ste 201
Stroudsburg, PA 18360-7566
Phone
(570) 476-6700
Fax
(570) 476-0735
NPI assigned
Sep 12, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2013

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

Authorized official

Name
Mrs. Bernie Lynch
Title
Business Office
Phone
(570) 476-9788

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

208 Lifeline Rd
Ste 201
Stroudsburg, PA 18360-7566

Mailing address

208 Lifeline Rd
Ste 201
Stroudsburg, PA 18360-7566
Phone (570) 476-6700

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0724502St Luke's Pocono Pediatric Associates Inc208 Lifeline Road, Suite 201, Stroudsburg, PA 18360Certificate of waiverAug 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
Pocono Pediatric Associates Inc2 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.

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367971200000",
    "number": "1932194446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 LIFELINE RD",
            "address_2": "STE 201",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183607566",
            "telephone_number": "570-476-6700",
            "fax_number": "570-476-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 LIFELINE RD",
            "address_2": "STE 201",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183607566",
            "telephone_number": "570-476-6700",
            "fax_number": "570-476-0735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POCONO PEDIATRIC ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-12",
        "last_updated": "2013-05-08",
        "status": "A",
        "authorized_official_last_name": "LYNCH",
        "authorized_official_first_name": "BERNIE",
        "authorized_official_title_or_position": "BUSINESS OFFICE",
        "authorized_official_telephone_number": "570-476-9788",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stroudsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.