NPIMap

Individual provider Active NPI

Keith Michael Pritchyk, M.D.

  • Otolaryngology Physician
  • Scranton, PA
National Provider Identifier
1063412583
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD423407 Issued in PA
Practice address
300 Lackawanna Ave Ste 200
Scranton, PA 18503-2001
Phone
(570) 342-7864
Fax
(570) 800-7515
NPI assigned
Jul 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD423407 PA Primary

Addresses

Primary practice location

300 Lackawanna Ave Ste 200
Scranton, PA 18503-2001

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311
Phone (484) 884-4500

Other identifiers 1

IdentifierTypeStateIssuer
1011302720001MedicaidPA

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
I20040607000597 PA Practitioner - Otolaryngology 4183606767 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Georgetown University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

3701 Corriere Rd
FL 2
Easton, PA 18045-7991
Phone (484) 591-7150

Hospital & facility affiliations

  • Lehigh Valley Hospital - Dickson City Hospital, Dickson City, PA, CCN 390338
  • Geisinger-Community Medical Center Hospital, Scranton, PA, CCN 390001
  • Wayne Memorial Hospital Hospital, Honesdale, PA, CCN 390125
  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270
  • Regional Hospital of Scranton Hospital, Scranton, PA, CCN 390237
  • Allied Services Institute of Rehabilitation Inpatient rehabilitation facility, Scranton, PA, CCN 393030

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Dec 28, 2021 Accepting new patients
Lehigh Valley Physician Group CurrentSince Dec 28, 2021 Accepting new patients
Delta Medix PC CurrentSince Jan 2, 2012 Accepting new patients
Vascular Diagnostic Center PC Past Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

2100 Mack Blvd
Fl 4
Allentown, PA 18103

3701 Corriere Rd
Fl 2
Easton, PA 18045
Phone (484) 591-7080

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

503 Sunset Dr
Olyphant, PA 18447
Phone (570) 489-4444

940 Jefferson Ave
Scranton, PA 18510
Phone (570) 346-7900

300 Lackawanna Ave
Unit 200
Scranton, PA 18503
Phone (570) 342-7864

300 Lackawanna Ave
#200
Scranton, PA 18503

5 Morgan Hwy
Ste 7
Scranton, PA 18508
Phone (570) 342-7864

300 Lackawanna Ave
Ste 200
Scranton, PA 18503
Phone (570) 342-7864

Interoperability endpoints

  • Direct secure messaging: kpritchyk636856@direct2.lvhn.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1063412583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LACKAWANNA AVE STE 200",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185032001",
            "telephone_number": "570-342-7864",
            "fax_number": "570-800-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRITCHYK",
        "first_name": "KEITH",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD423407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011302720001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.