NPIMap

Organization Active NPI

Wilkes Barre Hospital Company LLC

Doing business as Wilkes Barre General Hospital

  • Clinic/Center
  • Wilkes Barre, PA
National Provider Identifier
1053554378
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
WILKES BARRE HOSPITAL COMPANY LLC
Doing business as
Wilkes Barre General Hospital
Practice address
575 N River St
Wilkes Barre, PA 18764-0999
Phone
(570) 829-8111
NPI assigned
Apr 16, 2009
Last updated
May 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Authorized official

Name
Paula Lalor
Title
Director
Phone
(615) 925-4565

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Ambulatory Surgical Clinic/Center 261QA1903X

Addresses

Primary practice location

575 N River St
Wilkes Barre, PA 18764-0999

Mailing address

575 N River St
Wilkes Barre, PA 18764-0999
Phone (570) 829-8111

Other names 1

  • Wilkes Barre General Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090713000199 PA Part A Provider - Hospital 5890845754 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Nanticoke, PA; Wilkes Barre, PA; Wilke Barre, PA; Shaver Town, PA; Plains, PA; Pittston, PA; Exeter, PA; Forty Fort, PA…

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053554378. Details of each certification follow.

Hospital certification: CCN 390137

Legal name
WILKES BARRE HOSPITAL COMPANY LLC
Doing business as
WILKES BARRE GENERAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Sep 18, 2024
Beds
369 (335 certified)
Ownership / control type
Private (for profit)
Most recent change of ownership
May 1, 2009 (1 total)
Organization structure
LLCProprietary
Incorporated
Oct 30, 2008 in DE
Enrollment address
575 N River Street
Wilkes Barre General Hospital
Wilkes Barre, PA 18764-0999
Other Hospital Practice Location
Hospital subgroups
General, Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Wilkes-Barre General HospitalCCN 390137 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Wilkes-Barre Hospital Company LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

100 Upper Demunds Rd
Dallas, PA 18612
Phone (570) 674-9033

620 N Blakely St
Dunmore, PA 18512
Phone (570) 963-0277

468 Northampton St
#P
Edwardsville, PA 18704
Phone (570) 552-4500

239 S Mountain Blvd
Ste 200
Mountain Top, PA 18707
Phone (570) 715-7900

239 S Mountain Blvd
Ste 400
Mountain Top, PA 18707
Phone (570) 715-7900

670 S River St
Plains, PA 18705
Phone (570) 552-7197

672 S River St
Ste 201
Plains, PA 18705
Phone (570) 552-7810

1065 Highway 315 Blvd
Wilkes Barre, PA 18702
Phone (570) 829-6900

545 N River St
Ste 400
Wilkes Barre, PA 18702
Phone (570) 552-3110

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Roy Boyd Individual W-2 Managing EmployeeCfo Apr 17, 2025
Tenor Health Foundation, Inc. Organization, Pasadena, CA Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Jan 30, 2026 100%
Michael Bogert Individual Corporate OfficerChief Financial Officer Jan 30, 2026
Tenor Health Foundation, Wilkes Barre, LLC Organization, Pasadena, CA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 30, 2026 100%

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 597

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 597

NPI Registry JSON

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

{
    "created_epoch": "1239840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590624000000",
    "number": "1053554378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 N RIVER ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187640999",
            "telephone_number": "570-829-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 N RIVER ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187640999",
            "telephone_number": "570-829-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILKES BARRE HOSPITAL COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-16",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A",
        "authorized_official_last_name": "LALOR",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-925-4565"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilkes Barre General Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wilkes Barre General Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.