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EAST STROUDSBURG UNIVERSITY
NPI 1467927210
Orthopaedic Surgery in East Stroudsburg, PA

Active since October 09, 2018CLIA 39D2210785 · Waiver
200 PROSPECT ST, EAST STROUDSBURG, PA 18301(972) 367-4845 Get Directions Write a Review

NPPES record last updated: October 9, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About East Stroudsburg University NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EAST STROUDSBURG UNIVERSITY (NPI 1467927210), doing business as Esu Sports Medicine, is a healthcare organization registered as an orthopaedic surgery in East Stroudsburg, Pennsylvania and active in the NPI registry since October 2018. The organization holds a CLIA Waiver certificate valid through January 22, 2027 and lists Mouzon Bass, Administrator, as its authorized official.

NPPES Registry Identity

NPI1467927210
Entity TypeOrganization
Primary Taxonomy207X00000X
Legal Business NameEAST STROUDSBURG UNIVERSITY
Location Address200 PROSPECT STEast Stroudsburg, PA 18301-2956
Mailing Address5050 Spring Valley RdDallas, TX 75244-3995
Phone(972) 367-4845
Organization SubpartNo
Authorized OfficialMouzon BassAdministrator · (972) 367-4845
Enumeration DateOctober 9, 2018
✔ NPI 1467927210 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
200 PROSPECT ST, East Stroudsburg, PA 18301
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Other Names 1

Doing Business AsEsu Sports Medicine

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 39D2210785

East Stroudsburg University Student Health Center · East Stroudsburg, PA
Active · expires Jan 22, 2027
CLIA Number39D2210785
Laboratory TypePhysician Office
Certificate Effective DateJanuary 23, 2025
Certificate Expiration DateJanuary 22, 2027
Laboratory DirectorDr. Yelena Kipervas
Laboratory Phone(272) 762-4378
Laboratory LocationEast Stroudsburg University Student Health Center200 E Brown St, East Stroudsburg, PA 18301
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MERSADIE GRACE DIBBELL STUDENT
Student in an Organized Health Care Education/Training Program
200 PROSPECT ST
EAST STROUDSBURG, PA 18301
Monroe County (570) 422-3211
CHRISTIAN BAMPTON
Student in an Organized Health Care Education/Training Program
200 PROSPECT ST
EAST STROUDSBURG, PA 18301
Monroe County (484) 650-0078
SHANNON MICHELLE LEE
Student in an Organized Health Care Education/Training Program
200 PROSPECT ST
EAST STROUDSBURG, PA 18301
Monroe County (215) 622-0594
CAITLYN ROSE DARCZUK
Specialist/Technologist (Athletic Trainer)
200 PROSPECT ST
EAST STROUDSBURG, PA 18301
Monroe County (484) 467-4537
ADAM HARBAUGH
Specialist/Technologist (Athletic Trainer)
200 PROSPECT ST
EAST STROUDSBURG, PA 18301
Monroe County (570) 422-3211
RACHAEL ELISE WADDLE ATC
Specialist/Technologist (Athletic Trainer)
200 PROSPECT ST
EAST STROUDSBURG, PA 18301
Monroe County (570) 422-3165
TROY JONES
Student in an Organized Health Care Education/Training Program
200 PROSPECT ST
EAST STROUDSBURG, PA 18301
Monroe County (609) 414-8302
DR. GERARD D. ROZEA PHD
Specialist/Technologist (Athletic Trainer)
200 PROSPECT ST, 3 KOHLER FIELDHOUSE UNIVERSITY
EAST STROUDSBURG, PA 18301
Monroe County (570) 422-3065

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is East Stroudsburg University's NPI number?

The NPI number for East Stroudsburg University is 1467927210. It was assigned to this organization in the NPPES registry on October 9, 2018. The provider is doing business as ESU Sports Medicine.

Where is East Stroudsburg University located?

East Stroudsburg University is located at 200 Prospect St, East Stroudsburg, PA 18301. The listed phone number is (972) 367-4845.

What is East Stroudsburg University's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Does East Stroudsburg University hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D2210785) is associated with this NPI, valid through January 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for East Stroudsburg University was last updated on October 9, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.