NPIMap

Individual provider Active NPI

Patrick Kilduff, D.O.

  • Internal Medicine Physician
  • Wilkes Barre, PA
National Provider Identifier
1003857186
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS013069 Issued in PA
Practice address
440 N River St
Wilkes Barre, PA 18702-2631
Phone
(570) 825-5611
NPI assigned
Jun 9, 2006
Last updated
Jul 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS013069 PA Primary

Addresses

Primary practice location

440 N River St
Wilkes Barre, PA 18702-2631

Mailing address

610 Wyoming Ave
Kingston, PA 18704-3702
Phone (570) 288-5441

Other practice location 1

176 N Main St
Shavertown, PA 18708-1121
Phone (570) 675-0900

Other practice location 2

35 S Mountain Blvd
Mountain Top, PA 18707-1122
Phone (570) 474-5978

Other identifiers 2

IdentifierTypeStateIssuer
1016454140001MedicaidPA
1857047OtherPABLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060706000253 PA Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 2961414172 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospice/Palliative Care
Education
Philadelphia College of Osteopathic Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

35 S Mountain Blvd
Mountain Top, PA 18707-1122
Phone (570) 474-5072

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Mar 11, 2024 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Mar 11, 2024 Accepting new patients
Allied Services Personal Care, Inc Past Accepting new patients
Ecumenical Enterprises Inc Past Accepting new patients
Riverstreet Center Opco LLC Past Accepting new patients
Birchwood Rehabilitation and Healthcare LLC Past Accepting new patients
Timber Ridge SNF Operations LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Allied Services Personal Care, Inc Past Accepting new patients
Nanticoke Rehabilitation and Healthcare LLC Past Accepting new patients
Embassy of Tunkhannock LLC Past Accepting new patients

Locations

114 Lt Michael Cleary Dr
Dallas, PA 18612
Phone (570) 255-1178

100 N Academy Ave
Danville, PA 17822

499 Wyoming Ave
Kingston, PA 18704
Phone (570) 283-2161

560 Pierce St
Kingston, PA 18704
Phone (570) 283-2161

12 Kirby Ave
Mountain Top, PA 18707
Phone (570) 474-5978

57 N Main St
Pittston, PA 18640
Phone (570) 602-5620

35 S Mountain Blvd
Wilkes Barre, PA 18707
Phone (570) 474-5072

Interoperability endpoints

  • Direct secure messaging: pkilduff33980@direct.geisinger.edu

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Birchwood Rehabilitation & Healthcare CenterNanticoke, PA, CCN 395651 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2025
Apr 2, 2026

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 55

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 55

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1003857186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 WYOMING AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187043702",
            "telephone_number": "570-288-5441",
            "fax_number": "570-288-5842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 N RIVER ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187022631",
            "telephone_number": "570-825-5611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "176 N Main St",
            "address_purpose": "LOCATION",
            "city": "Shavertown",
            "state": "PA",
            "postal_code": "187081121",
            "country_code": "US",
            "telephone_number": "570-675-0900",
            "fax_number": "570-674-8912",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "35 S Mountain Blvd",
            "address_purpose": "LOCATION",
            "city": "Mountain Top",
            "state": "PA",
            "postal_code": "187071122",
            "country_code": "US",
            "telephone_number": "570-474-5978",
            "fax_number": "570-474-5485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILDUFF",
        "first_name": "PATRICK",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS013069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016454140001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1857047",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.