NPIMap

Organization Active NPI

East Penn Rheumatology

  • Rheumatology Physician
  • East Stroudsburg, PA
National Provider Identifier
1952440844
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
MD012628E Issued in PA
Legal business name
EAST PENN RHEUMATOLOGY
Practice address
600 Plaza CT
447 Office Plaza
East Stroudsburg, PA 18301-8263
Phone
(570) 424-9153
Fax
(570) 424-1046
NPI assigned
Feb 6, 2007
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
Dr. Charles L Ludivico, M.D.NPI 1750439147
Title
President
Phone
(610) 868-1336

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X MD012628E PA Primary

Addresses

Primary practice location

600 Plaza CT
447 Office Plaza
East Stroudsburg, PA 18301-8263

Mailing address

701 Ostrum St
Suite 501
Fountain Hill, PA 18015-1155
Phone (610) 868-1336

National Provider Directory

National Provider Directory
Tax ID family
East Penn Rheumatology2 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.

Locations

600 Plaza Ct
Ofc Plz
East Stroudsburg, PA 18301
Phone (570) 421-7020

701 Ostrum St
Ste 501
Fountain Hill, PA 18015
Phone (484) 526-6161

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952440844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 OSTRUM ST",
            "address_2": "SUITE 501",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180151155",
            "telephone_number": "610-868-1336",
            "fax_number": "610-332-3436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PLAZA CT",
            "address_2": "447 OFFICE PLAZA",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183018263",
            "telephone_number": "570-424-9153",
            "fax_number": "570-424-1046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST PENN RHEUMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUDIVICO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-868-1336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "PA",
            "license": "MD012628E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Stroudsburg, 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.