NPIMap

Organization Active NPI

Lebanon Surgical Associates, P.C.

  • Surgery Physician
  • Lebanon, PA
National Provider Identifier
1982743183
Registry record updated May 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD04154E Issued in PA
Legal business name
LEBANON SURGICAL ASSOCIATES, P.C.
Practice address
229 S 4TH St
Lebanon, PA 17042
Phone
(717) 273-2697
Fax
(717) 273-0126
NPI assigned
Feb 5, 2007
Last updated
May 14, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2012

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

Authorized official

Name
Dr. Robert A Bazewicz, MDNPI 1801008669
Title
Doctor
Phone
(717) 273-2697

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X MD04154E PA Primary

Addresses

Primary practice location

229 S 4TH St
Lebanon, PA 17042

Mailing address

229 S 4TH St
Lebanon, PA 17042
Phone (717) 273-2697

Other identifiers 1

IdentifierTypeStateIssuer
0011241650001MedicaidPA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336953600000",
    "number": "1982743183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 S 4TH ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "17042",
            "telephone_number": "717-273-2697",
            "fax_number": "717-273-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 S 4TH ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "17042",
            "telephone_number": "717-273-2697",
            "fax_number": "717-273-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEBANON SURGICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2012-05-14",
        "status": "A",
        "authorized_official_last_name": "BAZEWICZ",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "717-273-2697",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD04154E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011241650001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2012; 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.