NPIMap

Organization Active NPI

Lake Scranton Urgent Care LLC

  • Urgent Care Clinic/Center
  • Scranton, PA
National Provider Identifier
1194186957
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
LAKE SCRANTON URGENT CARE LLC
Practice address
1141 Moosic St
Suite 3
Scranton, PA 18505-2105
Phone
(570) 800-5926
Fax
(570) 955-5556
NPI assigned
Mar 8, 2016
Last updated
Mar 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Authorized official

Name
Brianne Balchune
Title
Office Manager
Phone
(570) 800-5926

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Emergency Care Clinic/Center 261QE0002X
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

1141 Moosic St
Suite 3
Scranton, PA 18505-2105

Mailing address

1141 Moosic St
Suite 3
Scranton, PA 18505-2105
Phone (570) 800-5926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170227000830 PA Part B Supplier - Clinic/Group Practice 0648554220 Receives reassigned benefits from 12 practitioners
Practice locations: Scranton, PA

National Provider Directory

National Provider Directory

Locations

1141 Moosic St
Ste 3
Scranton, PA 18505
Phone (570) 800-5926

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1194186957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 MOOSIC ST",
            "address_2": "SUITE 3",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185052105",
            "telephone_number": "570-800-5926",
            "fax_number": "570-955-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 MOOSIC ST",
            "address_2": "SUITE 3",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185052105",
            "telephone_number": "570-800-5926",
            "fax_number": "570-955-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE SCRANTON URGENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-08",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "BALCHUNE",
        "authorized_official_first_name": "BRIANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "570-800-5926"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.