Individual provider Active NPI

Holly Marie Drutarovsky, PA-C

  • Physician Assistant
  • Wilkes Barre, PA
National Provider Identifier
1184103764
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA060011 Issued in PA
Practice address
1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027
Phone
(570) 808-7300
NPI assigned
Aug 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X OA004573 PA
Neurology Physician 2084N0400X MA060011 PA
Physician Assistant 363A00000X MA060011 PA Primary

Addresses

Primary practice location

1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
MA060011OtherPAPENNSYLVANIA STATE BOARD OF MEDICINE LICENSE
OA004573OtherPAPENNSYLVANIA STATE BOARD OF OSTEOPATHIC MEDICINE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hdrutarovsky169599@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, SC, OH3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20180925000717 PA Practitioner - Physician Assistant 6204187602 Reassigns benefits to 1 organization
I20250319003542 SC Practitioner - Physician Assistant 6204187602 Reassigns benefits to 1 organization
I20250418000835 OH Practitioner - Physician Assistant 6204187602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians
The Metrohealth SystemGroup PAC ID 8628982949, 1,150 clinicians

Practice addresses (Care Compare)

169 Ashley Ave
Charleston, SC 29425-8905

2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (216) 778-7800

2500 Metrohealth Dr
Cleveland, OH 44109-1998

506 N St
Bamberg, SC 29003-1319
Phone (803) 245-6290

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OA004573PAMDNeurology Physician
MA060011PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Physician Assistant CurrentSince Sep 17, 2018 Accepting new patients
The Metrohealth System Current Accepting new patients
Musc Community Physicians CurrentSince Mar 1, 2025 Accepting new patients
The Metrohealth System CurrentSince Jan 29, 2025 Accepting new patients
Musc Community Physicians CurrentSince Mar 1, 2025 Accepting new patients
Geisinger Clinic CurrentSince Sep 17, 2018 Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties Past Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

549 Fair St
Bloomsburg, PA 17815
Phone (570) 387-2100

100 N Academy Ave
Danville, PA 17822

3 W Olive St
Scranton, PA 18508
Phone (570) 207-4054

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

Interoperability endpoints

  • Direct secure messaging: hdrutarovsky301324@direct.metrohealth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1184103764",
    "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": "570-271-6144",
            "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": "570-808-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRUTAROVSKY",
        "first_name": "HOLLY",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-14",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "OA004573",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MA060011",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA060011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA STATE BOARD OF MEDICINE LICENSE",
            "identifier": "MA060011",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA STATE BOARD OF OSTEOPATHIC MEDICINE LICENSE",
            "identifier": "OA004573",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hdrutarovsky169599@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.