Individual provider Active NPI

Michelle Pacyna, DO

  • Family Medicine Physician
  • Dunmore, PA
National Provider Identifier
1053014530
Registry record updated Jun 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS026221 Issued in PA
Practice address
1140 Quincy Ave
Dunmore, PA 18510-1150
Phone
(570) 983-0360
NPI assigned
Mar 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS026221 PA Primary

Addresses

Primary practice location

1140 Quincy Ave
Dunmore, PA 18510-1150

Mailing address

1140 Quincy Ave
Dunmore, PA 18510-1150
Phone (570) 983-0360

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230823002452 PA Order and Referring Only - Family PracticePractitioner - Family Practice 0446613426

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781913600000",
    "number": "1053014530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 QUINCY AVE",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185101150",
            "telephone_number": "570-983-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 QUINCY AVE",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185101150",
            "telephone_number": "570-983-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACYNA",
        "first_name": "MICHELLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-23",
        "last_updated": "2026-06-20",
        "certification_date": "2026-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS026221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunmore, PA

Sources for this page

Verify at the official NPI Registry.