Scranton Hospitalist Physician Services LLC
Organization Active NPI Diagnostic Radiology Physician · Scranton, PA
NPI 1023317849 · NPPES record last updated Sep 4, 2025
Key facts
- NPI
- 1023317849
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- SCRANTON HOSPITALIST PHYSICIAN SERVICES LLC
- Practice address
- 746 Jefferson Ave
4TH Floor
Scranton, PA 18510-1624 - Phone
- (570) 340-5079
- Fax
- (570) 340-5893
- NPI assigned
- Mar 18, 2011
- Organization subpart
- No
Authorized official
- Name
- Wendi Keeton
- Title
- Sr. Director Operations
- Phone
- (615) 628-6507
Member of 1
Practitioners 205
-
Guenadi Amoachi, MD
-
Ryan Michael Bonshock, M.D.
-
Ravi Kagali, M.D.
-
Ron Konecke, M.D.
-
John Lippert, M.D.
-
Mollie McGinley, M.D.
-
Shaun W. McLaughlin, M.D.
-
Luis L. Nadal, M.D.
-
Aalpen Patel, MD
-
Suman A Patel, MD
-
Martin Christopher Price, M.D.
-
Ann T Rolfs, MD
-
Nirav Shelat, D.O.
-
Salmi Simmons, M.D.
-
Ansar Z Vance, M.D.
-
Ryan Christopher Withrow, M.D.
-
Adel Abdalla, M.D.
-
Abbas A Chamsuddin, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (11 enrollments) in PA, FL, SC, CA, NY, IL, KY, MI, AL, NJ, KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110525000205 | PA | Part B Supplier - Clinic/Group Practice | 7719163831 |
Receives reassigned benefits from 72 practitioners Practice locations: Wyoming, PA; Wilkes Barre Township, PA; Wilkes Barre, PA; Shavertown, PA; Scranton, PA; Roaring Brook TWP, PA; North Abington Township, PA; Moosic, PA… |
| O20250611003334 | FL | Part B Supplier - Clinic/Group Practice | 7719163831 |
Receives reassigned benefits from 4 practitioners Practice locations: Tampa, FL; Orlando, FL; Hallandale Beach, FL; Melbourne, FL |
| O20250620000673 | SC | Part B Supplier - Clinic/Group Practice | 7719163831 |
Receives reassigned benefits from 1 practitioner Practice locations: Blythewood, SC |
| O20250620002832 | CA | Part B Supplier - Clinic/Group Practice | 7719163831 |
Receives reassigned benefits from 3 practitioners Practice locations: Huntington Beach, CA; Monterey Park, CA; Santa Monica, CA |
| O20250625002959 | NY | Part B Supplier - Clinic/Group Practice | 7719163831 |
Receives reassigned benefits from 3 practitioners Practice locations: Ithaca, NY; Mount Vernon, NY; New York, NY |
| O20250703001872 | IL | Part B Supplier - Clinic/Group Practice | 7719163831 |
Receives reassigned benefits from 1 practitioner Practice locations: South Barrington, IL |
| O20250721001930 | KY | Part B Supplier - Clinic/Group Practice | 7719163831 |
Receives reassigned benefits from 2 practitioners Practice locations: Lexington, KY |
| O20250811002164 | MI | Part B Supplier - Clinic/Group Practice | 7719163831 |
Receives reassigned benefits from 1 practitioner Practice locations: Orchard Lake, MI |
| O20250811004136 | AL | Part B Supplier - Clinic/Group Practice | 7719163831 |
Receives reassigned benefits from 1 practitioner Practice locations: Florence, AL |
| O20250814002506 | NJ | Part B Supplier - Clinic/Group Practice | 7719163831 |
Receives reassigned benefits from 1 practitioner Practice locations: Mount Laurel, NJ |
| O20260114003013 | KS | Part B Supplier - Clinic/Group Practice | 7719163831 |
Receives reassigned benefits from 1 practitioner Practice locations: Wichita, KS |
National Provider Directory
Locations
190 Welles St
Ste 102
Kingston, PA 18704
Phone (570) 288-0400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | Yes | ||
| Vascular & Interventional Radiology Physician |
2085R0204X | |||
| Hospitalist Physician |
208M00000X |
Addresses
Primary practice location
746 Jefferson Ave
4TH Floor
Scranton, PA 18510-1624
Mailing address
4000 Meridian Blvd
Franklin, TN 37067-6325
Phone (615) 465-7000
Other practice location 1
150 Mundy St
Wilkes-Barre Township, PA 18702-6804
Phone (877) 848-1457
Other practice location 2
190 Welles St
Forty Fort, PA 18704-4968
Phone (877) 848-1457
Other practice location 3
575 N River St
Wilkes Barre, PA 18702-2634
Phone (877) 848-1457
Other practice location 4
468 Northampton St
Edwardsville, PA 18704-4566
Phone (877) 848-1457
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102576840 0001 | Medicaid | PA |
Other providers in Scranton, PA
- Scranton Hospital Company LLC
- Scranton Hospital Company LLC
- Scranton Hospital Company LLC
- Scranton Hospital Company LLC
- Scranton Hospital Company LLC
- Scranton Neurological Associates PC
- Scranton Pharmacy Inc
- Scranton Primary Health Care Center, Inc
- Scranton Primary Health Care Center, Inc.
- Scranton Primary Health Care Center, Inc.
All providers in Scranton, PA · Diagnostic Radiology Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 4, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.