NPIMap

Individual provider Active NPI

Heather Renae Paduck, P.A.-C

  • Physician Assistant
  • Wilkes Barre, PA
National Provider Identifier
1174575229
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA002736L Issued in PA
Practice address
1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027
Phone
(570) 808-6026
Fax
(570) 808-3298
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA-002736-L PA
Physician Assistant 363A00000X MA002736L PA Primary

Addresses

Primary practice location

1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other identifiers 1

IdentifierTypeStateIssuer
150315K9MOtherPAMEDICARE PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hpaduck69884@direct.geisinger.edu Direct

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
I20070606000450 PA Practitioner - Physician Assistant 9436257995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 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

950 E Mountain Blvd
Wilkes Barre, PA 18702-7924
Phone (570) 808-5770

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA-002736-LPAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Sunbury Physician Assistant CurrentSince Dec 1, 2010 Accepting new patients
Geisinger Clinic CurrentSince Dec 1, 2010 Accepting new patients
Geisinger Clinic Past Accepting new patients
Wyoming Valley Pet Associates Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

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

950 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 808-3290

Interoperability endpoints

  • Direct secure messaging: hpaduck69884@direct.geisinger.edu

Organizations & group practices 5

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 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1174575229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E MOUNTAIN BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110027",
            "telephone_number": "570-808-6026",
            "fax_number": "570-808-3298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADUCK",
        "first_name": "HEATHER",
        "middle_name": "RENAE",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA-002736-L",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA002736L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "150315K9M",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hpaduck69884@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1000 E Mountain Blvd",
            "city": "Wilkes Barre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187110027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.