Stish Family Practice PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

STISH FAMILY PRACTICE PC

Practice address

600 Penn St
West Hazleton, PA 18202-1514

Phone

(570) 497-4940

Fax

(570) 497-4942

NPI assigned

Jun 27, 2006

Organization subpart

No

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

Authorized official

Name

Eugene Stish, MDNPI 1891746962

Title

President

Phone

(570) 788-1108

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 2

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

• Eugene R. Stish, MD

  • Family Medicine Physician
  • West Hazleton, PA
  • NPI 1891746962
  Medicare reassignment NPD Authorized official
• Joseph Bartolomeu Laczi, M.D.

  • Internal Medicine Physician
  • Marco Island, FL
  • NPI 1831325984
  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490659200000",
    "number": "1992732689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1388",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187040388",
            "telephone_number": "570-288-8881",
            "fax_number": "570-288-8065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PENN ST",
            "city": "WEST HAZLETON",
            "state": "PA",
            "postal_code": "182021514",
            "telephone_number": "570-497-4940",
            "fax_number": "570-497-4942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STISH FAMILY PRACTICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-27",
        "last_updated": "2017-03-28",
        "status": "A",
        "authorized_official_last_name": "STISH",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-788-1108",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BLUE SHIELD",
            "identifier": "514293",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH",
            "identifier": "002708",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa Maria Pelly, DMD
• Mary Ann Elizabeth Rother, OTR/L
• Jillian Marie Roush, PA-C
• Yamunadevi Sadasivan, M.D
• Amanda Sember
• Eugene R. Stish, MD
• Nicole Watson
• Cassandra Marie Yalch, PA-C
• Shane S Young, M.D.
• Joseph Edward Zola, PHARMD

• Family Medicine Physician in West Hazleton, PA
• Providers in West Hazleton, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; 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.

Verify at the official NPI Registry.