NPIMap

Individual provider Active NPI

Dariusz Piotr Bulczak, MD

  • Diagnostic Radiology Physician
  • Wilkes-Barre, PA
National Provider Identifier
1124011044
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD433190 Issued in PA
Practice address
1000 East Mountain Blvd
Wilkes-Barre, PA 18711-3446
Phone
(570) 808-7779
Fax
(570) 808-5390
NPI assigned
Aug 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 220495 NY
Diagnostic Radiology Physician 2085R0202X MD433190 PA Primary

Addresses

Primary practice location

1000 East Mountain Blvd
Wilkes-Barre, PA 18711-3446

Mailing address

100 North Academy Ave
Danville, PA 17822-4903
Phone (570) 808-7779

Other practice location 1

4 River Shores Ct
West Pittston, PA 18643-1950
Phone (952) 595-1100

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
I20161013000457 PA Practitioner - Diagnostic Radiology 0547345043 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger Clinic 3,432 clinicians
Geisinger-HM Joint Venture LLC 426 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

1000 E Mountain Dr
Wilkes Barre, PA 18711-0027
Phone (570) 826-7300

1201 Oak St
Pittston, PA 18640-3798
Phone (570) 808-9800

1800 Mulberry St
Scranton, PA 18510-2369
Phone (570) 969-7355

25 Church St
Wilkes Barre, PA 18702-3507
Phone (570) 808-3181

255 Route 220 Hwy
Muncy, PA 17756-7569
Phone (570) 308-2600

400 Highland Ave
Lewistown, PA 17044-1167
Phone (717) 363-9071

4200 Hospital Rd
Coal Township, PA 17866-9668
Phone (570) 644-4200

4203 Hospital Rd
Coal Township, PA 17866-9668
Phone (570) 648-4010

545 Fair St
Bloomsburg, PA 17815-1419
Phone (570) 387-2011

549 Fair St
Bloomsburg, PA 17815-1419
Phone (570) 387-2251

Hospital & facility affiliations

  • Geisinger Medical Center Hospital, Danville, PA, CCN 390006
  • Geisinger-Community Medical Center Hospital, Scranton, PA, CCN 390001
  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270
  • Geisinger-Bloomsburg Hospital Hospital, Bloomsburg, PA, CCN 390003

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
220495NYMDDiagnostic Radiology Physician
MD433190PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger-HM Joint Venture, LLC Diagnostic Radiology CurrentSince Jan 10, 2022 Accepting new patients
Geisinger-HM Joint Venture, LLC CurrentSince Jan 10, 2022 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic Diagnostic Radiology CurrentSince Nov 13, 2017 Accepting new patients
Ozarks Medical Center Diagnostic Radiology Past Accepting new patients
Advanced Radiology Services, PLLC Diagnostic Radiology Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Virtual Radiologic Professionals of Texas I, P.a. Diagnostic Radiology Past Accepting new patients

Locations

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

100 N Academy Ave
Danville, PA 17822

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

255 Route 220 Hwy
Muncy, PA 17756
Phone (570) 308-2600

1000 E Mountain Blvd
Wilkes Barre, PA 18711
Phone (570) 808-7399

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 58

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

View all 58

NPI Registry JSON

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1124011044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NORTH ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-808-7779",
            "fax_number": "570-808-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 EAST MOUNTAIN BLVD",
            "city": "WILKES-BARRE",
            "state": "PA",
            "postal_code": "187113446",
            "telephone_number": "570-808-7779",
            "fax_number": "570-808-5390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 River Shores Ct",
            "address_purpose": "LOCATION",
            "city": "West Pittston",
            "state": "PA",
            "postal_code": "186431950",
            "country_code": "US",
            "telephone_number": "952-595-1100",
            "fax_number": "612-294-4903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULCZAK",
        "first_name": "DARIUSZ",
        "middle_name": "PIOTR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "220495",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD433190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes-Barre, PA

Sources for this page

Verify at the official NPI Registry.