Active NPI 1548203284 Individual Practitioner Male Practitioner

Dr. Stephen A. Lewis , DO

Pediatrics • Sunbury, PA

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Stephen Lewis, DO is a certified Pediatrics practicing in Sunbury, PA. With approximately 29 years of clinical experience since graduating from Philadelphia College Of Osteopathic Medicine in 1997, Dr. Lewis delivers high-quality medical care to the local community at 385 STATE ST.

Dr. Lewis maintains professional affiliations with Geisinger Clinic, Phoenix Rehabilitation And Health Services Inc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's, established patient outpatient office visit, anticoagulant management of patient taking warfarin. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

385 State St

Sunbury, PA 178012531

Telephone 5702866773

Fax 5702867967

Associated Practice Facility / Clinic

🏢 Geisinger Clinic Sunbury Facility NPI 1740239243

Medicare Profile & Education

Medical School

Philadelphia College Of Osteopathic Medicine

Graduation Year

1997

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Sunbury, PA

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

29 Yrs Matches City Avg

City Avg: 29.0 Yrs

State Avg: 22.2 Yrs

Regional Practice Density

3 Specialists

Practicing in Sunbury, PA (3505 Statewide)

Telehealth Adoption Rate

33.3% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

61.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Lewis (29 Years) 29 Yrs

Sunbury Specialty Average (29.0 Years) 29.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	454	319	$42.00	$15.53
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	438	284	$316.92	$120.18
93793 Anticoagulant management of patient taking warfarin	191	69	$29.52	$10.68
85610 Blood test, clotting time	180	68	$62.50	$4.18
G0008 Administration of influenza virus vaccine	159	153	$72.74	$30.58
90662 Influenza vaccine split virus, preservative free	144	138	$135.00	$80.93
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	120	63	$140.00	$21.58
99213 Established patient office or other outpatient visit, typically 15 minutes	105	92	$213.33	$85.27
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	63	56	$445.16	$171.09
90471 Administration of 1 vaccine	56	55	$65.00	$19.24
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	43	43	$263.12	$122.43
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	42	21	$74.86	$12.07
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	33	29	$166.82	$50.41
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	26	13	$10.95	$1.02
90715 Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)	24	24	$95.00	$38.13
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	23	22	$92.52	$5.63
81003 Automated urinalysis test	23	22	$68.00	$2.20
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	21	12	$126.43	$39.15
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	16	16	$490.00	$289.78
G0009 Administration of pneumococcal vaccine	16	16	$63.75	$30.77

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	402	283	$301.79	$120.66
93793 Anticoagulant management of patient taking warfarin	209	87	$28.84	$10.97
85610 Blood test, clotting time	189	87	$80.28	$4.18
G0008 Administration of influenza virus vaccine	109	105	$54.45	$29.18
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	99	60	$137.58	$21.68
90662 Influenza vaccine split virus, preservative free	98	94	$114.04	$66.67
99213 Established patient office or other outpatient visit, typically 15 minutes	96	87	$204.90	$85.08
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	83	73	$421.98	$166.63
90471 Administration of 1 vaccine	65	61	$52.77	$18.80
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	62	22	$77.03	$13.15
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	49	14	$19.26	$1.45
G0009 Administration of pneumococcal vaccine	36	36	$51.67	$29.45
81003 Automated urinalysis test	34	30	$72.00	$2.20
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	34	34	$325.00	$281.47
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	29	29	$287.45	$123.15
90715 Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)	25	25	$70.04	$37.84
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	21	20	$96.38	$5.71
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	14	13	$165.00	$49.68
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$317.92	$107.89
69209 Removal of impacted ear wax by washing	12	12	$85.71	$14.99
90714 Vaccine for tetanus and diphtheria toxoids injection into muscle, patient 7 years or older	11	11	$33.00	$28.71
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	11	11	$98.64	$21.75
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	11	11	$367.18	$157.76

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	441	286	$287.83	$123.28
93793 Anticoagulant management of patient taking warfarin	260	103	$29.08	$10.98
G0008 Administration of influenza virus vaccine	159	154	$50.00	$27.65
90662 Influenza vaccine split virus, preservative free	142	137	$56.00	$54.64
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	122	71	$130.85	$22.01
85610 Blood test, clotting time	111	71	$88.78	$4.24
99213 Established patient office or other outpatient visit, typically 15 minutes	94	81	$195.74	$87.44
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	77	71	$403.95	$173.23
90471 Administration of 1 vaccine	51	47	$50.00	$15.46
G0009 Administration of pneumococcal vaccine	49	49	$50.00	$27.31
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	47	21	$67.55	$13.63
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	44	18	$19.09	$1.70
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	32	32	$315.69	$126.51
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	31	31	$313.55	$267.69
81003 Automated urinalysis test	22	20	$79.64	$2.22
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	18	18	$35.00	$17.51
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	18	18	$146.67	$51.42
99495 Transitional care management services for problem of at least moderate complexity	17	17	$475.00	$194.79
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	14	14	$122.00	$121.39

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	426	292	$261.37	$125.79
93793 Anticoagulant management of patient taking warfarin	398	125	$31.00	$11.16
85610 Blood test, clotting time	143	94	$38.81	$4.29
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	120	68	$138.82	$21.61
99213 Established patient office or other outpatient visit, typically 15 minutes	94	84	$177.77	$88.35
G0008 Administration of influenza virus vaccine	80	78	$47.94	$16.39
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	57	22	$13.60	$1.94
98967 Telephone medical discussion provided by nonphysician professional, 11-20 minutes	55	29	$209.75	$26.22
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	50	22	$64.20	$13.58
90662 Influenza vaccine split virus, preservative free	47	47	$56.00	$56.00
G0009 Administration of pneumococcal vaccine	36	36	$43.75	$16.39
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	34	34	$122.00	$121.76
36415 Insertion of needle into vein for collection of blood sample	32	32	$22.91	$3.00
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	30	26	$144.20	$51.47
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	27	27	$324.96	$129.34
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	24	23	$35.00	$20.45
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	24	24	$435.33	$164.18
81003 Automated urinalysis test	21	21	$64.33	$2.25
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	18	18	$360.83	$177.60
99495 Transitional care management services for problem of at least moderate complexity	16	12	$447.88	$200.89
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	15	11	$117.40	$39.88
90471 Administration of 1 vaccine	14	14	$45.71	$16.40

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	446	261	$221.37	$105.23
93793 Anticoagulant management of patient taking warfarin	349	137	$76.25	$11.53
G0008 Administration of influenza virus vaccine	169	165	$34.18	$16.24
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	120	120	$60.00	$60.00
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	68	39	$135.44	$21.83
99213 Established patient office or other outpatient visit, typically 15 minutes	64	57	$145.13	$73.45
G0009 Administration of pneumococcal vaccine	52	52	$31.65	$15.84
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	49	49	$35.00	$19.14
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	42	37	$294.05	$136.81
90471 Administration of 1 vaccine	30	30	$35.00	$13.88
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	30	30	$122.00	$113.26
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	28	24	$151.14	$51.99
98967 Telephone medical discussion provided by nonphysician professional, 11-20 minutes	25	14	$190.96	$27.55
90670 Pneumococcal vaccine for injection into muscle	24	24	$272.00	$223.15
90715 Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)	22	22	$69.00	$33.53
99442 Telephone medical discussion with physician, 11-20 minutes	21	21	$109.00	$70.57
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	15	15	$290.20	$113.24
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$225.23	$105.17
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	11	11	$144.45	$7.36

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	545	282	$195.00	$104.56
93793 Anticoagulant management of patient taking warfarin	533	164	$125.00	$11.88
G0008 Administration of influenza virus vaccine	173	163	$29.00	$15.95
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	169	159	$35.00	$18.65
99213 Established patient office or other outpatient visit, typically 15 minutes	132	99	$132.00	$71.88
36415 Insertion of needle into vein for collection of blood sample	115	112	$18.00	$2.94
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	80	48	$119.08	$21.69
G0009 Administration of pneumococcal vaccine	50	50	$29.00	$14.99
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	50	43	$273.00	$140.74
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	45	18	$70.00	$16.24
90471 Administration of 1 vaccine	41	41	$31.34	$16.25
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	40	14	$21.24	$1.80
90715 Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)	37	37	$69.00	$32.05
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	37	33	$158.00	$52.19
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	30	30	$115.67	$105.57
90670 Pneumococcal vaccine for injection into muscle	21	21	$272.00	$188.54
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	19	19	$145.00	$8.11
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	17	17	$275.00	$114.08
81003 Automated urinalysis test	15	13	$94.60	$2.44
99495 Transitional care management services for problem of at least moderate complexity	12	11	$264.33	$160.75

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
93793 Anticoagulant management of patient taking warfarin	736	195	$125.00	$11.74
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	591	292	$187.89	$103.23
36415 Insertion of needle into vein for collection of blood sample	464	244	$17.01	$2.94
G0008 Administration of influenza virus vaccine	213	206	$29.00	$19.39
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	212	205	$35.00	$18.47
99213 Established patient office or other outpatient visit, typically 15 minutes	146	122	$126.13	$71.03
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	56	38	$120.00	$20.26
G0009 Administration of pneumococcal vaccine	53	53	$29.00	$19.57
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	44	39	$267.91	$140.69
90471 Administration of 1 vaccine	39	39	$29.00	$19.67
90715 Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)	38	38	$68.47	$30.70
90670 Pneumococcal vaccine for injection into muscle	36	36	$272.00	$196.60
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	24	13	$70.00	$19.78
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	24	24	$275.00	$163.93
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	24	24	$275.00	$113.03
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	22	11	$21.38	$1.94
99495 Transitional care management services for problem of at least moderate complexity	21	21	$264.00	$159.07
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	21	18	$158.00	$52.13
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	16	16	$108.25	$103.48
81003 Automated urinalysis test	13	11	$90.23	$2.71
81002 Urinalysis, manual test	12	11	$98.25	$3.41

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	887	198	$119.83	$19.26
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	607	294	$177.03	$102.24
36415 Insertion of needle into vein for collection of blood sample	507	249	$15.45	$2.93
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	188	184	$35.00	$17.96
G0008 Administration of influenza virus vaccine	187	183	$29.00	$23.28
99213 Established patient office or other outpatient visit, typically 15 minutes	126	109	$119.37	$68.77
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	98	69	$257.67	$136.24
G0009 Administration of pneumococcal vaccine	53	53	$29.00	$24.05
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	41	33	$158.00	$51.81
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	36	36	$275.00	$164.95
90670 Pneumococcal vaccine for injection into muscle	30	30	$272.00	$186.52
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	25	25	$102.00	$95.47
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	18	18	$275.00	$111.44
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	16	15	$145.00	$7.94
81002 Urinalysis, manual test	14	12	$90.43	$3.43
81003 Automated urinalysis test	14	13	$82.71	$3.02
90471 Administration of 1 vaccine	13	13	$29.00	$24.15
90715 Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older)	12	12	$65.00	$29.89

Medical Specialties & State Licenses

CMS Verified: 2020-08-31

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License PA OS009936L

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Internal Medicine

NUCC Taxonomy Code: 207R00000X

State License PA OS009936L

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

001732301 (PA)

Hospital & Practice Group Affiliations

Geisinger Clinic

2200 W Front St, Berwick, PA 186034106

Phone: 5707592017

Phoenix Rehabilitation And Health Services Inc

2000 Westinghouse Dr, Cranberry Twp, PA 160665238

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners

Dr. Olivia Fladmark , MD

Family Medicine

NPI 1275196008

Doctor of Medicine (M.D.)

Julie Hamilton , PA-C

Family Medicine

NPI 1437176211

Physician Assistant (Certified)

Dr. Matthew Wolcott , MD

Internal Medicine

NPI 1467871459

Doctor of Medicine (M.D.)

Stacey Lauffer , PA-C

Physician Assistant

NPI 1558634105

Physician Assistant (Certified)

Molly Breskiewicz , CRNP

Nurse Practitioner

NPI 1568723146

Certified Registered Nurse Practitioner

Dr. Brian Timms , DO

Internal Medicine

NPI 1811955875

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Practice Location August 31, 2020

Registered at 385 STATE ST, SUNBURY, PA 178012531 (Tel: 5702866773)

📍

Updated Business Mailing Address August 31, 2020

Registered at 100 N ACADEMY AVE, DANVILLE, PA 178224903 (Tel: 5702716144)

✅

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location July 08, 2007

Registered at 2200 W FRONT ST, BERWICK, PA 186034106 (Tel: 5707591228)

📍

Updated Business Mailing Address July 08, 2007

Registered at 100 N ACADEMY AVE, DANVILLE, PA 178223034 (Tel: 5702716144)

👤

Provider Name / Credentials Updated July 08, 2007

Recorded as STEPHEN LEWIS, D.O.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Internal Medicine (License #OS009936L in PA)

🟢

Initial NPI Registration & Enumeration June 13, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews

No patient reviews submitted yet for Dr. Stephen Lewis. Be the first to share your experience!

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1548203284

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 13, 2006

Last Update: August 31, 2020

Sole Proprietor: No

Update or Correct Profile

Mailing Address

100 N Academy Ave

Danville, PA 178224903

Phone: 5702716144

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.