Active NPI
Northeast Critical Care LTD
- Family Medicine Physician
- Tamaqua, PA
National Provider Identifier
1992442255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- NORTHEAST CRITICAL CARE LTD
- Practice address
- 229 W Broad St
Tamaqua, PA 18252-1818 - Phone
- (570) 657-1634
- Fax
- (570) 645-3397
- NPI assigned
- May 18, 2022
- Organization subpart
- Yes
- Parent organization
- 000000
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David B Kasprzak, CRNP
- Title
- Ceo
- Phone
- (570) 657-1634
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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary | ||
| Clinic/Center | 261Q00000X | |||
| Multi-Specialty Clinic/Center | 261QM1300X | |||
| Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 335V00000X |
Addresses
Primary practice location
229 W Broad St
Tamaqua, PA 18252-1818
Mailing address
10 W White Bear Dr
Summit Hill, PA 18250-1728
Phone (570) 657-1634
Other names 2
- NCC Clinical Lab
- Valley Primary Care
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | admin@valleyprimarycare.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Northeast Critical Care LTD
- Part of
- Northeast Critical Care LTD
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinical Medical Laboratory
- Tamaqua, PA
- NPI 1942949177
-
- General Practice Physician
- Tamaqua, PA
- NPI 1124767355
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Tamaqua, PA
- NPI 1043654197
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652832000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1652832000000",
"number": "1992442255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 W WHITE BEAR DR",
"city": "SUMMIT HILL",
"state": "PA",
"postal_code": "182501728",
"telephone_number": "570-657-1634",
"fax_number": "570-645-3397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "229 W BROAD ST",
"city": "TAMAQUA",
"state": "PA",
"postal_code": "182521818",
"telephone_number": "570-657-1634",
"fax_number": "570-645-3397"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHEAST CRITICAL CARE LTD",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "000000",
"enumeration_date": "2022-05-18",
"last_updated": "2022-05-18",
"certification_date": "2022-05-18",
"status": "A",
"authorized_official_last_name": "KASPRZAK",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "570-657-1634",
"authorized_official_credential": "CRNP"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": null,
"license": null,
"primary": false
},
{
"code": "335V00000X",
"taxonomy_group": "",
"desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "admin@valleyprimarycare.org",
"affiliation": "N",
"endpointDescription": "Organization Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "229 W Broad St",
"city": "Tamaqua",
"state": "PA",
"country_code": "US",
"postal_code": "182521818",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "NCC Clinical Lab",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Valley Primary Care",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Tamaqua, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.