Individual provider Active NPI

Edward H Coronado, MD

  • Psychiatry Physician
  • Hanover, PA
National Provider Identifier
1942391040
Registry record updated Aug 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD036642E Issued in PA
Practice address
625 W Elm Ave
Hanover, PA 17331-5125
Phone
(717) 632-4900
Fax
(717) 632-4313
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD036642E PA Primary

Addresses

Primary practice location

625 W Elm Ave
Hanover, PA 17331-5125

Mailing address

625 W Elm Ave
Hanover, PA 17331-5125
Phone (717) 632-4900

Other identifiers 1

IdentifierTypeStateIssuer
0010730480006MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040202001003 PA Practitioner - Psychiatry 5991698292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Truenorth Wellness ServicesGroup PAC ID 6709869456, 20 clinicians

Practice addresses (Care Compare)

625 W Elm Ave
Hanover, PA 17331-5125
Phone (717) 632-4900

Hospital & facility affiliations

  • Gettysburg Hospital Hospital, Gettysburg, PA, CCN 390065
  • Wellspan York Hospital Hospital, York, PA, CCN 390046
  • Upmc Hanover Hospital, Hanover, PA, CCN 390233

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD036642EPAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Truenorth Wellness Services CurrentSince Apr 13, 2005 Accepting new patients
Truenorth Wellness Services CurrentSince Apr 13, 2005 Accepting new patients
Truenorth Wellness Services Past Accepting new patients
Merakey Pennsylvania Past Accepting new patients

Locations

295 State Dr
Elizabethville, PA 17023
Phone (717) 827-4636

625 W Elm Ave
Hanover, PA 17331

73 E Forrest Ave
Ste 340
Shrewsbury, PA 17361

1195 Roosevelt Ave
York, PA 17404
Phone (717) 843-0800

Organizations & group practices 4

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 8

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

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314316800000",
    "number": "1942391040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 W ELM AVE",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173315125",
            "telephone_number": "717-632-4900",
            "fax_number": "717-632-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W ELM AVE",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173315125",
            "telephone_number": "717-632-4900",
            "fax_number": "717-632-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORONADO",
        "first_name": "EDWARD",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2011-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD036642E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010730480006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, PA

Sources for this page

Verify at the official NPI Registry.