NPIMap

Geisinger Clinic

Organization Active NPI Family Medicine Physician · Wilkes Barre, PA

NPI 1073638201 · NPPES record last updated Jun 23, 2020

Key facts

NPI
1073638201
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
GEISINGER CLINIC
Practice address
166 Hanover St
Wilkes Barre, PA 18702-3549
Phone
(570) 808-8780
NPI assigned
Mar 20, 2007
Organization subpart
No

Authorized official

Name
Cindy L Mull
Title
Director
Phone
(570) 271-6144

Corporate family (same tax ID) 24

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

Practitioners 67

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

View all 67

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040130000518 PA Part B Supplier - Clinic/Group Practice 5395657001 Receives reassigned benefits from 5,323 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

Tax ID family
Geisinger Clinic Sunbury (275 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X Yes
Pediatrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208000000X
Physician Assistant
Group: 193200000X MULTI-SPECIALTY GROUP		 363A00000X
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363L00000X

Addresses

Primary practice location

166 Hanover St
Wilkes Barre, PA 18702-3549

Mailing address

100 N Academy Ave
Danville, PA 17822-3034
Phone (570) 271-5555

Other providers in Wilkes Barre, PA

All providers in Wilkes Barre, PA · Family Medicine Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.