NPIMap

Individual provider Active NPI

Samuel Edwin Schrack, D.O.

  • Family Medicine Physician
  • Laporte, PA
National Provider Identifier
1114926920
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS007012E Issued in PA
Practice address
217 King Street
Laporte, PA 18626-0095
Phone
(570) 946-5101
Fax
(570) 946-4341
NPI assigned
Jul 14, 2005
Last updated
Mar 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS007012E PA Primary

Addresses

Primary practice location

217 King Street
Laporte, PA 18626-0095

Mailing address

40 W Wellsboro St
Mansfield, PA 16933-1411
Phone (570) 662-1945

Other practice location 1

701 Northway Rd
Williamsport, PA 17701-3813
Phone (570) 327-9110

Other practice location 2

246 S Main St
Hughesville, PA 17737-1614
Phone (570) 584-5144

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
I20051025000386 PA Practitioner - Family Practice 8426075995 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

45 Mud Creek Rd
Troy, PA 16947-9529
Phone (570) 297-3746

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS007012EPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Penn Comprehensive Health Services CurrentSince Mar 24, 2025 Accepting new patients
North Penn Comprehensive Health Services CurrentSince Mar 24, 2025 Accepting new patients
Rural Health Corporation of Northeastern Pennsylvania Family Medicine CurrentSince Nov 18, 2021 Accepting new patients
Rural Health Corporation of Northeastern Pennsylvania Current Accepting new patients
Rural Health Corporation of Northeastern Pennsylvania Family Medicine CurrentSince Nov 18, 2021 Accepting new patients
North Penn Comprehensive Health Services Family Medicine Current Accepting new patients
North Penn Comprehensive Health Services Past Accepting new patients
North Penn Comprehensive Health Services Past Accepting new patients
North Penn Comprehensive Health Services Past Accepting new patients
North Penn Comprehensive Health Services Past Accepting new patients

Locations

6 Riverside Plz
Blossburg, PA 16912
Phone (570) 638-2174

103 Forestview Ave
Elkland, PA 16920
Phone (814) 258-5117

1730 E Broad St
Hazleton, PA 18201
Phone (570) 455-3656

32 E Lawrence Rd
Lawrenceville, PA 16929
Phone (570) 827-0125

40 W Wellsboro St
Mansfield, PA 16933
Phone (570) 662-1945

416 S Main St
Mansfield, PA 16933
Phone (570) 662-1900

26 N Main St
Shickshinny, PA 18655
Phone (570) 542-4141

410 Main St
Ste 102
Towanda, PA 18848
Phone (570) 266-5882

45 Mud Creek Rd
Troy, PA 16947
Phone (570) 297-3746

7 Water St
Wellsboro, PA 16901
Phone (570) 724-1010

236 E Main St
Westfield, PA 16950
Phone (814) 367-5911

276 E End Ctr
Wilkes Barre, PA 18702
Phone (570) 825-8741

Interoperability endpoints

  • Direct secure messaging: samuel.schrack@upmcdirect.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1114926920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 W WELLSBORO ST",
            "city": "MANSFIELD",
            "state": "PA",
            "postal_code": "169331411",
            "telephone_number": "570-662-1945",
            "fax_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 KING STREET",
            "city": "LAPORTE",
            "state": "PA",
            "postal_code": "186260095",
            "telephone_number": "570-946-5101",
            "fax_number": "570-946-4341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Northway Rd",
            "address_purpose": "LOCATION",
            "city": "Williamsport",
            "state": "PA",
            "postal_code": "177013813",
            "country_code": "US",
            "telephone_number": "570-327-9110",
            "fax_number": "570-327-1181",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "246 S Main St",
            "address_purpose": "LOCATION",
            "city": "Hughesville",
            "state": "PA",
            "postal_code": "177371614",
            "country_code": "US",
            "telephone_number": "570-584-5144",
            "fax_number": "570-584-5416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHRACK",
        "first_name": "SAMUEL",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS007012E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laporte, PA

Sources for this page

Verify at the official NPI Registry.