Pinnacle Treatment Centers PA-IX, LLC

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

Legal business name

PINNACLE TREATMENT CENTERS PA-IX, LLC

Practice address

534 W Broad St
Hazleton, PA 18201-6108

Phone

(570) 497-5173

NPI assigned

Mar 4, 2021

Organization subpart

No

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

Authorized official

Name

Robyn Tanis

Title

Executive Director of Contract MGMT

Phone

(856) 533-8762

Specialties & licenses 2

Addresses

Other names 1

• Hazleton Treatment Services Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Opioid treatment program

Medicare-enrolled since Mar 24, 2022

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amanda M T Godfrey, DO

  • Family Medicine Physician
  • Mountain Top, PA
  • NPI 1710265715
  NPD

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635292800000",
    "number": "1073108734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 ROUTE 73 STE 200",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542202",
            "telephone_number": "856-439-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 W BROAD ST",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182016108",
            "telephone_number": "570-497-5173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE TREATMENT CENTERS PA-IX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A",
        "authorized_official_last_name": "TANIS",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF CONTRACT MGMT",
        "authorized_official_telephone_number": "856-533-8762"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hazleton Treatment Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hazleton Treatment Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Homiler Elie Phanor
• Physicisns Clinical Laboratory
• Constance M Piccolo
• Courtenay Pientka
• Pindar Physical Therapy Inc
• Jeffrey Platek, MPT
• Thomas Joseph Plaza, MPT
• Plus 1 RX, LLC
• Jenyne Marie Podlinski, PA-C
• Frank Charles Polidora, MD

• Methadone Clinic in Hazleton, PA
• Providers in Hazleton, PA by specialty
• Methadone Clinic in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.