NPIMap

Individual provider Active NPI

Andrea Marissa Tomassoni, MD

  • Obstetrics & Gynecology Physician
  • Scranton, PA
National Provider Identifier
1104896042
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD070234L Issued in PA
Practice address
521 Mt Pleasant Dr
Suite 101
Scranton, PA 18503-1987
Phone
(570) 346-7338
Fax
(570) 341-3025
NPI assigned
Jan 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD070234L PA Primary

Addresses

Primary practice location

521 Mt Pleasant Dr
Suite 101
Scranton, PA 18503-1987

Mailing address

521 Mt Pleasant Dr
Suite 101
Scranton, PA 18503-1987
Phone (570) 346-7338

Other identifiers 1

IdentifierTypeStateIssuer
0018016230004MedicaidPA

Other names 1

  • Mrs. Andrea Marissa Granko Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address andrea.tomassoni.1@21771.direct.athenahealth.com

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
I20040908001009 PA Practitioner - Obstetrics/Gynecology 1557337862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Pennsylvania State University College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scranton Quincy Clinic Company LLCGroup PAC ID 0143487389, 66 clinicians

Practice addresses (Care Compare)

315 S Main St
Old Forge, PA 18518-1606
Phone (570) 457-8364

Hospital & facility affiliations

  • Wilkes-Barre General Hospital Hospital, Wilkes-Barre, PA, CCN 390137
  • Geisinger-Community Medical Center Hospital, Scranton, PA, CCN 390001
  • Regional Hospital of Scranton Hospital, Scranton, PA, CCN 390237

Merit-based Incentive Payment System (MIPS)

Final score
89.17 of 100Reported as apm
Quality
78.34
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD070234LPAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scranton Quincy Clinic Company LLC CurrentSince Jan 1, 2012 Accepting new patients
Scranton Quincy Clinic Company LLC Obstetrics & Gynecology CurrentSince Jan 1, 2012 Accepting new patients
Scranton Hospital Company LLC Past Accepting new patients

Locations

150 Brooklyn St
Carbondale, PA 18407
Phone (570) 282-2031

315 S Main St
Old Forge, PA 18518
Phone (570) 457-8364

521 Mt Pleasant Dr
Ste 101
Scranton, PA 18503
Phone (570) 346-7338

Organizations & group practices 3

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1104896042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 MT PLEASANT DR",
            "address_2": "SUITE 101",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185031987",
            "telephone_number": "570-346-7338",
            "fax_number": "570-341-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 MT PLEASANT DR",
            "address_2": "SUITE 101",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185031987",
            "telephone_number": "570-346-7338",
            "fax_number": "570-341-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMASSONI",
        "first_name": "ANDREA",
        "middle_name": "MARISSA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD070234L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018016230004",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "andrea.tomassoni.1@21771.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "521 Mt Pleasant Dr",
            "address_2": "Suite 101",
            "city": "Scranton",
            "state": "PA",
            "country_code": "US",
            "postal_code": "185031987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "GRANKO",
            "middle_name": "MARISSA",
            "prefix": "MRS.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.