NPIMap

Individual provider Active NPI

Shaymal Mozumdar, MD

  • Internal Medicine Physician
  • Easton, PA
National Provider Identifier
1972563898
Registry record updated Apr 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD449953 Issued in PA
Practice address
3735 Nazareth Rd Ste 301
Easton, PA 18045-8347
Phone
(610) 829-2200
Fax
(610) 829-2211
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 192233 NY
Internal Medicine Physician 207R00000X MD449953 PA Primary

Addresses

Primary practice location

3735 Nazareth Rd Ste 301
Easton, PA 18045-8347

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311
Phone (484) 884-4500

Other identifiers 8

IdentifierTypeStateIssuer
0100918OtherGHI
0409243OtherNYINDEPENDENT HEALTH
000523007009OtherNYBLUE CROSS
040426003599OtherNYFIDELIS
110235049OtherRAILROAD MEDICARE
145302BJOtherPREFERRED CARE
01476613MedicaidNY
00020501801OtherNYUNIVERA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131213001134 PA Practitioner - Internal Medicine 5193795763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

3735 Nazareth Rd
301 George M Joseph MD and Associates
Easton, PA 18045-8347
Phone (610) 829-2200

Hospital & facility affiliations

  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133
  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049
  • St Luke'S Warren Hospital Hospital, Phillipsburg, NJ, CCN 310060

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Apr 9, 2018 Accepting new patients
Lehigh Valley Physician Group Internal Medicine Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Apr 9, 2018 Accepting new patients
Niagara Hospitalist, PC Past Accepting new patients
Shaymal Mozumdar M.D. P.C. Internal Medicine PastSince Oct 1, 2003 Accepting new patients
Harnath Clerk MD PC Internal Medicine Past Accepting new patients

Locations

3735 Nazareth Rd
Ste 301
Easton, PA 18045
Phone (610) 258-2826

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

Organizations & group practices 7

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 12

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1972563898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3735 NAZARETH RD STE 301",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180458347",
            "telephone_number": "610-829-2200",
            "fax_number": "610-829-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOZUMDAR",
        "first_name": "SHAYMAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "192233",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD449953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0100918",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "0409243",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000523007009",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040426003599",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110235049",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "145302BJ",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01476613",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00020501801",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, PA

Sources for this page

Verify at the official NPI Registry.