Individual provider Active NPI

Luper Isaac Kohol

  • Student in an Organized Health Care Education/Training Program
  • Wilkes-Barre, PA
National Provider Identifier
1184419467
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1000 East Mountain Blvd
Wilkes-Barre, PA 18711
Phone
(570) 808-3746
NPI assigned
Apr 9, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1000 East Mountain Blvd
Wilkes-Barre, PA 18711

Mailing address

1000 East Mountain Blvd
Wilkes-Barre, PA 18711
Phone (570) 808-3746

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251028002527 PA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 7416446760

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1744156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1184419467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 EAST MOUNTAIN BLVD",
            "city": "WILKES-BARRE",
            "state": "PA",
            "postal_code": "18711",
            "telephone_number": "570-808-3746"
        },
        {
            "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": "18711",
            "telephone_number": "570-808-3746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHOL",
        "first_name": "LUPER",
        "middle_name": "ISAAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-09",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes-Barre, PA

Sources for this page

Verify at the official NPI Registry.