NPIMap

Organization Active NPI

Geisinger Wyoming Valley Medical Center

  • Diagnostic Radiology Physician
  • Pittston, PA
National Provider Identifier
1104292960
Registry record updated Oct 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
GEISINGER WYOMING VALLEY MEDICAL CENTER
Practice address
42 North Main St
Pittston, PA 18640
Phone
(570) 654-0880
NPI assigned
Aug 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2015

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

Authorized official

Name
Cindy L Mull
Title
Director Credentialing/Enrollments
Phone
(570) 271-6603

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

42 North Main St
Pittston, PA 18640

Mailing address

100 North Academy Avenue
Danville, PA 17822-4903
Phone (570) 271-5555

Other names 1

  • Geisinger Pittston Radiology, a Service of GWV Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040901000618 PA Part A Provider - Hospital 5092780023 21 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wilkes Barre, PA; Wilkes-Barre, PA; Wilkes -Barre, PA; Dallas, PA; Dickson City, PA; Forty Fort, PA; Mountain Top, PA; Mountaintop, PA…

Hospital certification: CCN 390270

Legal name
GEISINGER WYOMING VALLEY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Apr 20, 1981
Last certification
Sep 4, 2025
Beds
356 (317 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Feb 2, 1976 in PA
Enrollment address
1000 East Mountain Drive
GWV Op Surgery
Wilkes Barre, PA 18711-0027
Other Hospital Practice Location
Hospital subgroups
General, Acute care

Other NPIs on the same Medicare enrollment 19

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

View all 19

National Provider Directory

National Provider Directory
Tax ID family
Rad NPW Fund23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Terry Gilliland Individual Corporate Officer Mar 1, 2025
Daniel J Gaydon Individual Corporate OfficerAssociate Vice President, Finance Jan 1, 2026
W-2 Managing Employee Jan 1, 2026
William Schultz Individual Corporate OfficerVice President & Cfo Jan 1, 2026
W-2 Managing Employee Jan 1, 2026
Jeffrey a Jacobson Individual Corporate Officer Jan 1, 2019
Chris Holcombe Individual Corporate Officer Jan 1, 2017
Benjamin K Chu Individual Corporate Director Jan 1, 2020
Virginia McGregor Individual Corporate Officer Jan 1, 2017
Jason Mitchell Individual Corporate Officer Jan 1, 2026
Megan Brosious Individual Corporate Officer Mar 1, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Affiliated clinicians 1,567

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

View all 1,567

Care Compare: Hospital

Medicare Care Compare
Listed as
Geisinger Wyoming Valley Medical CenterCCN 390270
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

NPI Registry JSON

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443744000000",
    "number": "1104292960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NORTH ACADEMY AVENUE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-5555",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 NORTH MAIN ST",
            "city": "PITTSTON",
            "state": "PA",
            "postal_code": "18640",
            "telephone_number": "570-654-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEISINGER WYOMING VALLEY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-17",
        "last_updated": "2015-10-02",
        "status": "A",
        "authorized_official_last_name": "MULL",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR CREDENTIALING/ENROLLMENTS",
        "authorized_official_telephone_number": "570-271-6603"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Geisinger Pittston Radiology, a Service of GWV",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pittston, PA

Sources for this page

Verify at the official NPI Registry.