Eugene J Chiavacci, M.D.
Individual provider Active NPI Specialist · Old Forge, PA
NPI 1992794630 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1992794630
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- MD027185E (PA)
- Practice address
- 730 S Main St
Old Forge, PA 18518-1459 - Phone
- (570) 457-3300
- Fax
- (570) 457-4878
- NPI assigned
- Oct 16, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD027185E | PA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allied Services Institute of Rehabilitation Medicine | Past | Accepting new patients | |
| Community Medical Care, Inc | Past | Accepting new patients | |
| Allied Services Institute of Rehabilitation Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MD027185E | PA | Yes |
Addresses
Primary practice location
730 S Main St
Old Forge, PA 18518-1459
Mailing address
730 S Main St
Old Forge, PA 18518-1459
Phone (570) 457-3300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00920915 | Medicaid | PA |
Other providers in Old Forge, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.