SCHUYLKILL HEALTH SYSTEM MEDICAL GROUP, INC. (NPI# 1063073823) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063073823 |
| Entity Type | Organization |
| Organization Name | SCHUYLKILL HEALTH SYSTEM MEDICAL GROUP, INC. |
| Other Organization Name | LVPG EXPRESSCARE SCHUYLKILL |
| Practice Address |
200 Schuylkill Medical Plz Pottsville PA 17901-3660 |
| Mailing Address |
Po Box 783311 Philadelphia PA 19178-3311 |
| Practice Telephone | 5706219200 |
| Practice Fax Number | 5706219201 |
| Mailing Telephone | 4848844500 |
| Mailing Fax Number | 4848840699 |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2020-08-16 |
| Authorized Official Name | JAMES DEMOPOULOS (SR VP & COO LVPG) |
| Authorized Official Telephone | 4848623333 |
| Is Organization Subpart | Y |
| Parent Organization Name | SCHUYLKILL HEALTH SYSTEM MEDICAL GROUP, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| LVPG ExpressCare Schuylkill | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588603567 | Schuylkill Health System Medical Group, Inc. | Psychiatry & Neurology | 205 E Laurel Blvd, Pottsville, PA 17901-2534 | 2006-06-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SCHUYLKILL HEALTH SYSTEM MEDICAL GROUP, INC. | 420 S Jackson St, Pottsville, PA 17901-3625 |
| Street Address |
200 SCHUYLKILL MEDICAL PLZ |
| City | POTTSVILLE |
| State | PA |
| Zip Code | 17901-3660 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083641260 | Stephen Evans | Family Medicine | 200 Schuylkill Medical Plz, Pottsville, PA 17901-3660 | 2006-06-26 |
| 1417508425 | Brianna Malia Gaylets | Physician Assistant | 200 Schuylkill Medical Plz, Pottsville, PA 17901-3660 | 2019-09-23 |
| 1346711157 | Beth A Vanselous | Nurse Practitioner | 200 Schuylkill Medical Plz, Pottsville, PA 17901 | 2018-12-06 |
| 1750891511 | Jenna Williams | Physician Assistant | 200 Schuylkill Medical Plz, Pottsville, PA 17901 | 2017-10-06 |
| 1194255273 | Priyanka Lauber | Emergency Medicine | 200 Schuylkill Medical Plz, Pottsville, PA 17901-3660 | 2017-06-12 |
| 1568990869 | Kathryn Brooke Bartlett | Emergency Medicine | 200 Schuylkill Medical Plz, Pottsville, PA 17901-3660 | 2017-05-31 |
| 1720516024 | John Daubert | Emergency Medicine | 200 Schuylkill Medical Plz, Pottsville, PA 17901 | 2017-05-31 |
| 1063940377 | Claire Paulson | Emergency Medicine | 200 Schuylkill Medical Plz, Pottsville, PA 17901 | 2017-05-31 |
| 1255869558 | Robert Aaron Gyory | Emergency Medicine | 200 Schuylkill Medical Plz, Pottsville, PA 17901 | 2017-05-31 |
| 1003357864 | Daniel Torrens | Emergency Medicine | 200 Schuylkill Medical Plz, Pottsville, PA 17901 | 2017-03-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013409762 | Culture2culture, Inc. | Community/Behavioral Health | 110 E Arch St Fl 1, Pottsville, PA 17901 | 2018-05-30 |
| 1376059444 | Stacie Marie Herring | Registered Nurse | 1400 Laurel Boulevard, Pottsville, PA 17901 | 2017-12-27 |
| 1477092567 | Dr. Scott Rosenthal, P.C. | Pain Medicine | 48 Tunnel Rd Ste 202, Pottsville, PA 17901 | 2017-02-22 |
| 1932573268 | Allied Health Care Services | Community/Behavioral Health | 320 N Second St, Pottsville, PA 17901 | 2015-11-24 |
| 1417344862 | Megan Heffron-foose | Behavioral Analyst | 221 Mahantongo Street, Pottsville, PA 17901 | 2015-04-23 |
| 1326443417 | Richard Adam Haycock | Psychiatry & Neurology | 16 South Centre St, Pottsville, PA 17901 | 2014-10-31 |
| 1245647296 | Maria Gustis | Counselor | 100 Greenbriar Road, Pottsville, PA 17901 | 2014-07-22 |
| 1790198398 | Michelle Chilinskas | Pharmacist | 500 N Claude Lord Blvd, Pottsville, PA 17901 | 2014-06-11 |
| 1952720153 | Darcie Nan Roeder | Physical Therapy Assistant | 700 E Norwegian St., Pottsville, PA 17901 | 2014-04-15 |
| 1205180858 | Rocky Mountain Holdings LLC | Ambulance | 1394 Cedar St, Pottsville, PA 17901 | 2012-11-05 |
| Find all providers in zip 17901 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841249216 | Eric Alan Goldman | Emergency Medicine | 700 East Norwegian St, Pottsville, PA 17901-2798 | 2006-05-10 |
| 1689623324 | Haywood Blum | Emergency Medicine | Good Samaritan Regional Medical Center, Emergency Dept, 700 E Norwegian St, Pottsville, PA 17901 | 2006-05-09 |
| 1194255273 | Priyanka Lauber | Emergency Medicine | 200 Schuylkill Medical Plz, Pottsville, PA 17901-3660 | 2017-06-12 |
| 1568990869 | Kathryn Brooke Bartlett | Emergency Medicine | 200 Schuylkill Medical Plz, Pottsville, PA 17901-3660 | 2017-05-31 |
| 1720516024 | John Daubert | Emergency Medicine | 200 Schuylkill Medical Plz, Pottsville, PA 17901 | 2017-05-31 |
| 1063940377 | Claire Paulson | Emergency Medicine | 200 Schuylkill Medical Plz, Pottsville, PA 17901 | 2017-05-31 |
| 1255869558 | Robert Aaron Gyory | Emergency Medicine | 200 Schuylkill Medical Plz, Pottsville, PA 17901 | 2017-05-31 |
| 1003357864 | Daniel Torrens | Emergency Medicine | 200 Schuylkill Medical Plz, Pottsville, PA 17901 | 2017-03-13 |
| 1609224716 | Amy Wier | Emergency Medicine | 200 Schuylkill Medical Plz, Pottsville, PA 17901 | 2016-05-31 |
| 1518315639 | Zachary Matuzsan | Emergency Medicine | 200 Schuylkill Medical Plz, Pottsville, PA 17901 | 2016-05-31 |
| Find all providers in POTTSVILLE | ||||
| City | POTTSVILLE |
| Zip Code | 17901 |
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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.