Ismail O. Dedeoglu, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD064845L Issued in PA

Practice address

21 Geisinger LN
Lewistown, PA 17044-3400

Phone

(717) 242-4200

Fax

(717) 242-4212

NPI assigned

Feb 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Scranton, PA
  • NPI 1770990160
  NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Pottsville, PA
  • NPI 1043261183

  Pediatrics

  NPD (past)
• Geisinger Clinic

  • Hospitalist Physician
  • Wilkes Barre, PA
  • NPI 1588614358
  NPD (past)

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1104892355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178223034",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 GEISINGER LN",
            "city": "LEWISTOWN",
            "state": "PA",
            "postal_code": "170443400",
            "telephone_number": "717-242-4200",
            "fax_number": "717-242-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDEOGLU",
        "first_name": "ISMAIL",
        "middle_name": "O.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD064845L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001688141",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "idedeoglu67126@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "21 Geisinger Ln",
            "city": "Lewistown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170443400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brooke Davenport, PA-C
• David a Eichenlaub & Gary R Bodmer, Partners
• Patricia A Davis
• Debbie N Goldberg LLC
• Deborah L Fiume, DMD
• Sandy Dejoie
• Melissa Delancey, LCSW
• Dennis M. Devita, M.D. P.C.
• Kimberly Kathleen Deutsch, PMHNP
• Dennis M Devita, M.D.

• Pediatrics Physician in Lewistown, PA
• Providers in Lewistown, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.