BLOOMSBURG PHYSICIAN SERVICES (NPI# 1124236708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124236708 |
| Entity Type | Organization |
| Organization Name | BLOOMSBURG PHYSICIAN SERVICES |
| Other Organization Name | BLOOMSBURG PHYSICIAN SERVICES OBGYN |
| Practice Address |
410 Glenn Ave Suite 2 Bloomsburg PA 17815-1200 |
| Practice Telephone | 5703872474 |
| Practice Fax Number | 5703872397 |
| Mailing Telephone | 5703872474 |
| Mailing Fax Number | 5703872397 |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JOSEPH DEVITO (CFO) |
| Authorized Official Telephone | 5703872148 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1015090000002 | 05 | |
| PA | GHP NUMBER | 94984 | 01 |
| PA | CBC NUMBER | 50052725 | 01 |
| PA | HIGHMARK NUMBER | 1388085 | 01 |
| PA | FIRST PRIORITY | 819545 | 01 |
| Other Name | Type Code |
|---|---|
| BLOOMSBURG PHYSICIAN SERVICES OBGYN | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811913536 | Bloomsburg Physician Services | Family Medicine | 401 Glenn Ave, Bloomsburg, PA 17815-1247 | 2006-07-14 |
| 1770790974 | Bloomsburg Physician Services | Surgery | 410 Glenn Ave, Suite 203, Bloomsburg, PA 17815-1200 | 2007-05-17 |
| Street Address |
410 GLENN AVE SUITE 2 |
| City | BLOOMSBURG |
| State | PA |
| Zip Code | 17815-1200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366448268 | Columbia Montour Home Health Services Vna, Inc. | Home Health | 410 Glenn Ave, Suite 200, Bloomsburg, PA 17815-1200 | 2005-06-24 |
| 1326572363 | Kayla Zambiasi | Registered Nurse | 410 Glenn Ave, Bloomsburg, PA 17815-1200 | 2017-04-17 |
| 1184042350 | Lisa Foster | Registered Nurse | 410 Glenn Ave, Suite 200, Bloomsburg, PA 17815-1200 | 2014-04-03 |
| 1659702975 | Mid-state Occupational Health Services, Inc. | Clinic/Center | 410 Glenn Ave, Suite 2, Bloomsburg, PA 17815-1200 | 2013-12-12 |
| 1245665967 | Columbia Montour Home Health Svcs., Vna | Home Health | 410 Glenn Ave, Suite 200, Bloomsburg, PA 17815-1200 | 2013-09-12 |
| 1073956272 | Christine L Resele | Registered Nurse | 410 Glenn Ave, Suite200, Bloomsburg, PA 17815-1200 | 2013-04-08 |
| 1487097671 | Christine Marie Hayes | Registered Nurse | 410 Glenn Ave, Suite 200, Bloomsburg, PA 17815-1200 | 2013-04-08 |
| 1871732883 | Anita Lynn Rose | Registered Nurse | 410 Glenn Ave, Suite 200, Bloomsburg, PA 17815-1200 | 2009-02-13 |
| 1447412317 | Donna Rae Pauling | Registered Nurse | 410 Glenn Ave, Suite 200, Bloomsburg, PA 17815-1200 | 2008-07-01 |
| 1295905487 | Kelly Sue Kishbaugh | Physical Therapist | 410 Glenn Ave, Suite 101, Bloomsburg, PA 17815-1200 | 2008-03-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780295733 | Geisinger Clinic | Emergency Medicine | 545 Fair Street, Bloomsburg, PA 17815 | 2020-08-13 |
| 1124457551 | Patricia Marie Archey | Physician Assistant | 93 Avon Ave, Bloomsburg, PA 17815 | 2013-11-06 |
| 1154684561 | Alice Michele Weaver Maczuga | Social Worker | 816 Central Road, Bollmsburg, PA 17815 | 2012-06-20 |
| 1396069332 | Cmsu Behavioral Health and Developmental Services | Community/Behavioral Health | 675 Locust St, Bloomsburg, PA 17815 | 2010-03-19 |
| 1922235829 | Joel Stephen Hamilton | Dentist | 2 Audubon Court, Bloomsburg, PA 17815 | 2009-06-18 |
| 1508011685 | Cindy A Prosseda | Social Worker | 6850 Lowes Road, Bloomsburg, PA 17815 | 2008-11-17 |
| 1881854271 | Francis Joseph Welk | Physical Therapist | 410 Glen Ave, Suite 101 Susquehanna Physical Therapy Associates, Bloomsburg, PA 17815 | 2008-06-10 |
| 1679652390 | John A Scerbo | Dentist | 812 Central Road, Bloomsburg, PA 17815 | 2006-11-03 |
| 1104914811 | Columbia Ancillary Services Inc | Durable Medical Equipment & Medical Supplies | 1141 Ridge Road, Bloomsburg, PA 17815 | 2006-10-10 |
| 1922192681 | Patricia M. Taylor | Speech-Language Pathologist | 6530 Main Street, Bloomsburg, PA 17815 | 2006-10-03 |
| Find all providers in zip 17815 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144531260 | Felicia Helene Hawkins | Obstetrics & Gynecology | 425 E 1st St, Bloomsburg, PA 17815-1480 | 2010-06-23 |
| 1548451305 | Robert Leslie Lozo | Obstetrics & Gynecology | 6850 Lows Road, Bloomsburg, PA 17815 | 2007-08-07 |
| 1649497967 | Julie Messimer | Obstetrics & Gynecology | 425 E 1st St, Bloomsburg, PA 17815-1480 | 2007-04-19 |
| 1437235157 | Myron Levine | Obstetrics & Gynecology | 425 E 1st St, Suite101, Bloomsburg, PA 17815-1480 | 2006-10-27 |
| 1811952161 | Michael Kenneth Kowalski | Obstetrics & Gynecology | 6850 Lows Road, Bloomsburg, PA 17815 | 2006-04-19 |
| 1881694099 | Richard Tomczyk Jr. | Obstetrics & Gynecology | 6850 Lows Rd, Suite 325, Bloomsburg, PA 17815-8729 | 2005-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871103069 | Kongoormutt Ramakrishna Bhat | Obstetrics & Gynecology | 3 Jamison Dr, York, PA 17402-2615 | 2020-08-03 |
| 1811515307 | St. Luke's Physician Group, Inc. | Obstetrics & Gynecology | 3311 Nazareth Rd Fl 1, Easton, PA 18045-2017 | 2020-07-10 |
| 1962027557 | Tal Avigal Lee | Obstetrics & Gynecology | 1109 Green St Apt 11, Philadelphia, PA 19123-3326 | 2020-06-10 |
| 1184257826 | St. Luke's Physician Group Inc., Dba | Obstetrics & Gynecology | 2925 William Penn Hwy Ste 104, Easton, PA 18045-5283 | 2020-02-21 |
| 1821633694 | Julia Claire Moran | Obstetrics & Gynecology | 1800 Union Ave, Natrona Heights, PA 15065-2201 | 2019-11-15 |
| 1851957948 | Stacie Marie Rickley | Obstetrics & Gynecology | 1265 New Germany Rd, Summerhill, PA 15958-5301 | 2019-05-14 |
| 1477011401 | Diane D. Harrison | Obstetrics & Gynecology | 236 Philip Pl, Philadelphia, PA 19106-3902 | 2019-03-08 |
| 1003387572 | Carissa Susan Mcilwain | Obstetrics & Gynecology | 25 Bala Ave Ste 205, Bala Cynwyd, PA 19004-3215 | 2018-12-10 |
| 1720570963 | Tiffany Fernandes Gee | Obstetrics & Gynecology | 3401 N Broad St Fl 7, Philadelphia, PA 19140-5189 | 2018-06-04 |
| 1689164196 | St. Luke's Physician Group Inc. | Obstetrics & Gynecology | 450 Chew St Ste 204, Allentown, PA 18102-3434 | 2018-05-10 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMSBURG |
| Zip Code | 17815 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.