Organization Active NPI

Pediatrics of Nepa, PC

  • Pediatrics Physician
  • Dickson City, PA
National Provider Identifier
1023199098
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRICS OF NEPA, PC
Practice address
920 Viewmont Drive
Dickson City, PA 18519
Phone
(570) 346-1464
Fax
(570) 346-7450
NPI assigned
Oct 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Authorized official

Name
John Marx, MDNPI 1184764060
Title
Partner
Phone
(570) 346-1464

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

920 Viewmont Drive
Dickson City, PA 18519

Mailing address

920 Viewmont Drive
Dickson City, PA 18519
Phone (570) 346-1464

Other names 1

  • Drs Dawgert Zukoski & Welby PC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040622000378 PA Part B Supplier - Clinic/Group Practice 6800871062 Receives reassigned benefits from 1 practitioner
Practice locations: Dickson City, PA

National Provider Directory

National Provider Directory

Locations

920 Viewmont Dr
Scranton, PA 18519
Phone (570) 346-1464

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612483200000",
    "number": "1023199098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 VIEWMONT DRIVE",
            "city": "DICKSON CITY",
            "state": "PA",
            "postal_code": "18519",
            "telephone_number": "570-346-1464",
            "fax_number": "570-346-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 VIEWMONT DRIVE",
            "city": "DICKSON CITY",
            "state": "PA",
            "postal_code": "18519",
            "telephone_number": "570-346-1464",
            "fax_number": "570-346-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRICS OF NEPA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A",
        "authorized_official_last_name": "MARX",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "570-346-1464",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drs Dawgert Zukoski & Welby PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Drs Dawgert Zukoski & Welby PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Dickson City, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.