PETER LEROUX (NPI# 1306882279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306882279 |
| Entity Type | Individual |
| Full Name | PETER LEROUX |
| Credential | MD |
| Practice Address |
100 E Lancaster Ave Suite 370 Medical Science Building Wynnewood PA 19096-3450 |
| Mailing Address |
Po Box 100265 Gainesville FL 32610-0265 |
| Practice Telephone | 6106423005 |
| Practice Fax Number | 6106423057 |
| Mailing Telephone | 3522739000 |
| Mailing Fax Number | 3523928413 |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2019-03-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207T00000X | Neurological Surgery | ME139330 | FL | Allopathic & Osteopathic Physicians |
| Y | 207T00000X | Neurological Surgery | MD072435L | PA | Allopathic & Osteopathic Physicians |
| Street Address |
100 E LANCASTER AVE SUITE 370 MEDICAL SCIENCE BUILDING |
| City | WYNNEWOOD |
| State | PA |
| Zip Code | 19096-3450 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003819079 | Robert D. Smink Jr. | Surgery | 100 E Lancaster Ave, Wynnewood, PA 19096-3450 | 2005-05-24 |
| 1164021713 | Clay Johnson | Physician Assistant | 100 E Lancaster Ave, Wynnewood, PA 19096-3450 | 2020-10-23 |
| 1447858725 | Anthony Montello | Nurse Anesthetist, Certified Registered | 100 E Lancaster Ave, Wynnewood, PA 19096-3450 | 2020-10-09 |
| 1982216107 | Delaware Valley I.d. Associates, P.C. | Clinic/Center | 100 E Lancaster Ave, Mob East 556, Wynnewood, PA 19096 | 2020-08-19 |
| 1831708551 | Farouk Al Chami | Student in an Organized Health Care Education/Training Program | 100 E Lancaster Ave, Wynnewood, PA 19096-3450 | 2020-07-28 |
| 1225647944 | Farah Olleik | Internal Medicine | 100 E Lancaster Ave, Wynnewood, PA 19096-3450 | 2020-07-28 |
| 1134738859 | Talar Telvizian | Student in an Organized Health Care Education/Training Program | 100 E Lancaster Ave, Wynnewood, PA 19096-3450 | 2020-07-28 |
| 1962011833 | Fares Sukhon | Student in an Organized Health Care Education/Training Program | 100 E Lancaster Ave, Wynnewood, PA 19096-3450 | 2020-07-27 |
| 1700494028 | Aviad Lavian | Internal Medicine | 100 E Lancaster Ave, Wynnewood, PA 19096-3450 | 2020-07-22 |
| 1700404472 | Dalia Amrom | Internal Medicine | 100 E Lancaster Ave, Wynnewood, PA 19096-3450 | 2020-07-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831727866 | Jeffrey Glenn Johnston | Hospitalist | Lankenau Medical Center. 100 E Lancaster Ave, Wynnewood, PA 19096 | 2020-03-27 |
| 1326500331 | Maitri Pancholy | Student in an Organized Health Care Education/Training Program | Annenberg Center, G-10, 100 Lancaster Avenue, Wynnewood, PA 19096 | 2019-04-01 |
| 1306355987 | Karie Elizabeth Melton | Social Worker | 250 E Wynnewood Rd E12, Wynnewood, PA 19096 | 2017-09-26 |
| 1518320662 | Kaitlyn Kennard | Surgery | 100 Lancaster Ave Mob South Suite 422, Wynnewood, PA 19096 | 2016-04-05 |
| 1366814675 | Linda Elkins | Counselor | 543 Haverford Rd, Wynnewood, PA 19096 | 2015-10-26 |
| 1619347655 | Tessa Kovick | Registered Nurse | 100 E Lancaster Ave Ste 114, Wynnewood, PA 19096 | 2015-10-02 |
| 1922476415 | Amy Lenrow | Skilled Nursing Facility | 1510 Powder Mill Lane, Wynnewood, PA 19096 | 2015-09-14 |
| 1144602855 | Casey Dajao | Internal Medicine | 100 E Lancaster Ave Ste 140, Wynnewood, PA 19096 | 2015-06-18 |
| 1649666223 | Benjamin Larson | Internal Medicine | 100 E Lancaster Ave Ste B11, Wynnewood, PA 19096 | 2015-04-10 |
| 1760873285 | Kathleen Gilmartin | Nurse Practitioner | 100 East Lancaster Ave, Wynnewood, PA 19096 | 2015-02-06 |
| Find all providers in zip 19096 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154566800 | Bruce Edgar Northrup | Neurological Surgery | 317 Hathaway Ln, Wynnewood, PA 19096-1904 | 2008-12-10 |
| 1912206301 | Gaurav Jain | Neurological Surgery | 100 E Lancaster Ave Ste 256, Wynnewood, PA 19096 | 2011-03-24 |
| 1831198258 | Stephen L Fedder Md PC | Neurological Surgery | 100 E Lancaster Ave, Suite 655, Wynnewood, PA 19096-3450 | 2005-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033754510 | Isabela Marlene Tetino | Neurological Surgery | 1029 Maplewood Dr, Canonsburg, PA 15317-6058 | 2019-11-08 |
| 1326608779 | Pascal Lavergne | Neurological Surgery | 111 11th St, Thomas Jefferson University, Philadelphia, PA 19107 | 2019-06-18 |
| 1003475120 | Michael Bradley Avery | Neurological Surgery | 909 Walnut Street, 2nd Floor, Philadelphia, PA 19107-5211 | 2019-06-12 |
| 1427573492 | Mercy Management of Sepa | Neurological Surgery | 2701 Holme Ave Ste 305, Phila, PA 19152-2029 | 2017-08-10 |
| 1730625450 | Nir Shimony | Neurological Surgery | 100 N. Academy Ave., Geisinger Medical Center, Neurosurgery Department, Danville, PA 17822 | 2017-01-19 |
| 1083002661 | Excela Health Physician Practices, Inc. | Neurological Surgery | 100 Excela Health Dr Ste 203b, Latrobe, PA 15650-9001 | 2015-01-05 |
| 1780006874 | Donald Reigel | Neurological Surgery | 1139 Links Way, Gibsonia, PA 15044-7725 | 2014-01-09 |
| 1962832782 | Ronald Larry Paul | Neurological Surgery | 5550 Nursery Road, Dover, PA 17315 | 2013-11-14 |
| 1457787434 | Allegheny Clinic | Neurological Surgery | 575 Coal Valley Rd Ste 260, Clairton, PA 15025-3716 | 2013-09-23 |
| 1144666348 | Sean Patrick Polster | Neurological Surgery | 203 Lothrop St Ste 521, Pittsburgh, PA 15213-2548 | 2013-05-14 |
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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.