Individual provider Active NPI

Todd J. Holmes, M.D.

  • Emergency Medicine Physician
  • Wilkes Barre, PA
National Provider Identifier
1184693384
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD043652E Issued in PA
Practice address
25 Church St
Wilkes Barre, PA 18765-0001
Phone
(570) 808-3100
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD043652E PA
Emergency Medicine Physician 207P00000X MD043652E PA Primary

Addresses

Primary practice location

25 Church St
Wilkes Barre, PA 18765-0001

Mailing address

100 N Academy Ave
Danville, PA 17822-3034
Phone (570) 271-6144

Other identifiers 1

IdentifierTypeStateIssuer
001673514MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tholmes69200@direct.geisinger.edu Direct

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
I20060124000107 PA Practitioner - Emergency Medicine 9234153701 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD043652EPAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne Memorial Hospital CurrentSince May 4, 2024 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Jan 1, 2008 Accepting new patients
Wayne Memorial Hospital Internal Medicine CurrentSince May 4, 2024 Accepting new patients
Geisinger Clinic CurrentSince Jan 1, 2008 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

601 Park St
Honesdale, PA 18431
Phone (570) 253-8100

25 Church St
Wilkes Barre, PA 18765
Phone (570) 826-3100

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

1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300

Interoperability endpoints

  • Direct secure messaging: tholmes69200@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.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1184693384",
    "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": "178223034",
            "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": "25 CHURCH ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187650001",
            "telephone_number": "570-808-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "TODD",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD043652E",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD043652E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001673514",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tholmes69200@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "25 Church St",
            "city": "Wilkes Barre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187650001",
            "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.