Organization Active NPI

Primary Focus Medicine Inc

  • Family Medicine Physician
  • Dickson Cty, PA
National Provider Identifier
1114700689
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PRIMARY FOCUS MEDICINE INC
Practice address
1550 Main St
Dickson Cty, PA 18447-1345
Phone
(570) 218-8055
Fax
(570) 550-0869
NPI assigned
Aug 17, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Authorized official

Name
Carolina Favero Brag, MD
Title
MD
Phone
(570) 218-8055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1550 Main St
Dickson Cty, PA 18447-1345

Mailing address

1550 Main St
Dickson Cty, PA 18447-1345
Phone (570) 218-8055

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240121000053 PA Part B Supplier - Clinic/Group Practice 0446602957 Receives reassigned benefits from 8 practitioners
Practice locations: Dickson Cty, PA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2308755Primary Focus Medicine1550 Main Street, Suite #1B, Dickson City, PA 18447Certificate of waiverAug 1, 2026

National Provider Directory

National Provider Directory

Locations

1550 Main St
Ste 1B
Dickson Cty, PA 18447
Phone (570) 218-8055

1330 Main St
#141
Scranton, PA 18519

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1692230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1114700689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 MAIN ST",
            "city": "DICKSON CTY",
            "state": "PA",
            "postal_code": "184471345",
            "telephone_number": "570-218-8055",
            "fax_number": "570-550-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 MAIN ST",
            "city": "DICKSON CTY",
            "state": "PA",
            "postal_code": "184471345",
            "telephone_number": "570-218-8055",
            "fax_number": "570-550-0869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY FOCUS MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-17",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A",
        "authorized_official_last_name": "BRAG",
        "authorized_official_first_name": "CAROLINA",
        "authorized_official_middle_name": "FAVERO",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "570-218-8055",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickson Cty, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; 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.