Northeastern Pennsylvania Plastic Surgery Associates LTD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

MD017502E Issued in PA

Legal business name

NORTHEASTERN PENNSYLVANIA PLASTIC SURGERY ASSOCIATES LTD

Practice address

1222 Marion St
Dunmore, PA 18509-2458

Phone

(570) 347-1712

Fax

(570) 963-0534

NPI assigned

Sep 26, 2007

Organization subpart

No

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

Authorized official

Name

Eric W Blomain, MDNPI 1093724510

Title

Physician

Phone

(570) 347-1712

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

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

• Eric W Blomain, M.D.

  • Plastic Surgery Physician
  • Scranton, PA
  • NPI 1093724510
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297641600000",
    "number": "1992992796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 MARION ST",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185092458",
            "telephone_number": "570-347-1712",
            "fax_number": "570-963-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 MARION ST",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185092458",
            "telephone_number": "570-347-1712",
            "fax_number": "570-963-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEASTERN PENNSYLVANIA PLASTIC SURGERY ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2011-02-14",
        "status": "A",
        "authorized_official_last_name": "BLOMAIN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "570-347-1712",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "PA",
            "license": "MD017502E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Plastic Surgery Physician in Dunmore, PA
• Providers in Dunmore, PA by specialty
• Plastic Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; 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.