NPIMap

Individual provider Active NPI

Pavel Pribula, M.D.

  • Internal Medicine Physician
  • Berwick, PA
National Provider Identifier
1043210628
Registry record updated Oct 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD067594L Issued in PA
Practice address
751 E 16TH St
Suite 300
Berwick, PA 18603-2321
Phone
(570) 752-5056
Fax
(570) 752-0841
NPI assigned
Jul 26, 2005
Last updated
Oct 8, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2010

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 MD067594L PA Primary

Addresses

Primary practice location

751 E 16TH St
Suite 300
Berwick, PA 18603-2321

Mailing address

751 E 16TH St
Suite 300
Berwick, PA 18603-2321
Phone (570) 752-5056

Other identifiers 9

IdentifierTypeStateIssuer
48130OtherPAGEISINGER HEALTH PLAN
002112OtherPAFIRST PRIORITY HEALTH
001794117/0004MedicaidPA
160150OtherPAKEYSTONE HEALTH PLAN CENT
01089801OtherPACAPITAL BLUE CROSS
CQ88OtherPAHEALTH AMERICA/HEALTH ASS
P006026OtherPAGATEWAY HEALTH PLAN
160150OtherPAHIGHMARK
PR160150OtherPAHEALTH ONE

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
I20040122001087 PA Practitioner - Internal Medicine 8325940075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

751 E 16TH St
Suite 300
Berwick, PA 18603-2321

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.69 of 100Reported as apm
Quality
85.57
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD067594LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine of Berwick PC Inc Internal Medicine CurrentSince Mar 1, 1999 Accepting new patients
Berwick Clinic Company LLC Internal Medicine Past Accepting new patients
Berwick Medical Professionals PC Past Accepting new patients
Glen Brook Rehabilitation and Healthcare Center LLC Past Accepting new patients

Locations

751 E 16th St
Ste 300
Berwick, PA 18603
Phone (570) 752-5056

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1704/brand/1/csg/81/fhir/r4

Organizations & group practices 4

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 56

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

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286496000000",
    "number": "1043210628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 E 16TH ST",
            "address_2": "SUITE 300",
            "city": "BERWICK",
            "state": "PA",
            "postal_code": "186032321",
            "telephone_number": "570-752-5056",
            "fax_number": "570-752-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 E 16TH ST",
            "address_2": "SUITE 300",
            "city": "BERWICK",
            "state": "PA",
            "postal_code": "186032321",
            "telephone_number": "570-752-5056",
            "fax_number": "570-752-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIBULA",
        "first_name": "PAVEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2010-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD067594L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PLAN",
            "identifier": "48130",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH",
            "identifier": "002112",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001794117/0004",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN CENT",
            "identifier": "160150",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "01089801",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA/HEALTH ASS",
            "identifier": "CQ88",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HEALTH PLAN",
            "identifier": "P006026",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "160150",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ONE",
            "identifier": "PR160150",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwick, PA

Sources for this page

Verify at the official NPI Registry.