Individual provider Active NPI

Renee E Schaefer, D.M.D., M.S.

  • Dentist
  • Scranton, PA
National Provider Identifier
1174842173
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DSO38230 Issued in PA
Practice address
959 Wyoming Ave
Scranton, PA 18509-3023
Phone
(570) 504-0882
NPI assigned
May 31, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DSO38230 PA Primary

Addresses

Primary practice location

959 Wyoming Ave
Scranton, PA 18509-3023

Mailing address

920 Wildflower Dr
Plains, PA 18702-7932
Phone (570) 604-9369

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211115000541 PA Practitioner - Dentist 2163711276 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DSO38230PAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Medical Oncology Lock Haven CurrentSince Nov 15, 2021 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Nov 15, 2021 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

675 Baltimore Dr
Wilkes Barre, PA 18702
Phone (570) 808-5757

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1275264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1174842173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 WILDFLOWER DR",
            "city": "PLAINS",
            "state": "PA",
            "postal_code": "187027932",
            "telephone_number": "570-604-9369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "959 WYOMING AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185093023",
            "telephone_number": "570-504-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFER",
        "first_name": "RENEE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-31",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DSO38230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.