Individual provider Active NPI

Edward R Stankiewicz, MD

  • Internal Medicine Physician
  • Linwood, PA
National Provider Identifier
1972504066
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD 039652-L Issued in PA
Practice address
1579 Chichester Ave
Linwood, PA 19061-4208
Phone
(610) 485-5800
Fax
(610) 485-1421
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD 039652-L PA Primary

Addresses

Primary practice location

1579 Chichester Ave
Linwood, PA 19061-4208

Mailing address

1579 Chichester Ave
Linwood, PA 19061-4208
Phone (610) 485-5800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address edwardstankiewicz@direct.practicefusion.com

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
I20081224000293 PA Practitioner - Internal MedicinePractitioner - General Practice 8729140801 Practice locations: Linwood, PA

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: General Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1579 Chichester Ave
Linwood, PA 19061-4208
Phone (610) 485-5800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 039652-LPAMDInternal Medicine Physician

Hospital & facility affiliations 2

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1972504066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1579 CHICHESTER AVE",
            "city": "LINWOOD",
            "state": "PA",
            "postal_code": "190614208",
            "telephone_number": "610-485-5800",
            "fax_number": "610-485-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1579 CHICHESTER AVE",
            "city": "LINWOOD",
            "state": "PA",
            "postal_code": "190614208",
            "telephone_number": "610-485-5800",
            "fax_number": "610-485-1421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANKIEWICZ",
        "first_name": "EDWARD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD 039652-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edwardstankiewicz@direct.practicefusion.com",
            "affiliation": "N",
            "address_1": "1579 Chichester Ave",
            "city": "Linwood",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190614208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Linwood, PA

Sources for this page

Verify at the official NPI Registry.