Wyoming Valley Infectious Disease Assoc, PC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

Legal business name

WYOMING VALLEY INFECTIOUS DISEASE ASSOC, PC

Practice address

545 N River St
Suite 205
Wilkes Barre, PA 18702-2600

Phone

(570) 822-6036

Fax

(570) 829-1520

NPI assigned

May 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Gary R Decker, MDNPI 1144279209

Title

Owner

Phone

(570) 822-6036

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 5

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

• Gary Raymond Decker, MD

  • Infectious Disease Physician
  • Wilkes Barre, PA
  • NPI 1144279209
  Medicare reassignment Care Compare group NPD Authorized official
• Lucyann M Sciandra, DO

  • Infectious Disease Physician
  • Wilkes Barre, PA
  • NPI 1326096884
  Medicare reassignment Care Compare group NPD
• Michael J. Gehman, DO

  • Infectious Disease Physician
  • Las Vegas, NV
  • NPI 1912973041

  PA

  Medicare reassignment Care Compare group NPD
• Linda A Slavoski, MD

  • Infectious Disease Physician
  • Wilkes Barre, PA
  • NPI 1386693687
  Medicare reassignment NPD
• Mary Louise Susan Decker, MD

  • Infectious Disease Physician
  • Scranton, PA
  • NPI 1598714891
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290124800000",
    "number": "1154372373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 N RIVER ST",
            "address_2": "SUITE 205",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187022600",
            "telephone_number": "570-822-6036",
            "fax_number": "570-829-1520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 N RIVER ST",
            "address_2": "SUITE 205",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187022600",
            "telephone_number": "570-822-6036",
            "fax_number": "570-829-1520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYOMING VALLEY INFECTIOUS DISEASE ASSOC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2010-11-19",
        "status": "A",
        "authorized_official_last_name": "DECKER",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-822-6036",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "756235",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY",
            "identifier": "809669",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "010284600",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PLAN",
            "identifier": "5507",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017767900002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY LIFE",
            "identifier": "756235",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Infectious Disease Physician in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Infectious Disease Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.