Geisinger Clinic

Organization Active NPI Family Medicine Physician · Berwick, PA

NPI 1194776526 · NPPES record last updated Nov 11, 2021

Key facts

NPI
1194776526
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
GEISINGER CLINIC
Practice address
W 2200 Front St
Berwick, PA 18603
Phone
(570) 759-1228
NPI assigned
May 12, 2006
Organization subpart
No

Authorized official

Name
Cindy Mull
Title
Director
Phone
(570) 271-6144

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040130000518 PA Part B Supplier - Clinic/Group Practice 5395657001 Receives reassigned benefits from 5,323 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

Tax ID family
Geisinger Clinic Sunbury (275 organizations share this tax ID)

Locations

42 N Scott St
Carbondale, PA 18407
Phone (570) 282-6660

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes
Clinical Pathology/Laboratory Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207ZP0105X
Diagnostic Radiology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2085R0202X
Clinical Medical Laboratory 291U00000X PA
Durable Medical Equipment & Medical Supplies 332B00000X
Physician Assistant
Group: 193200000X MULTI-SPECIALTY GROUP
363A00000X
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363L00000X

Addresses

Primary practice location

W 2200 Front St
Berwick, PA 18603

Mailing address

100 N Academy Ave
Danville, PA 17822-3034

Other practice location 1

6850 Lows Road
Bloomsburg, PA 17815-8708
Phone (570) 316-5700

Other providers in Berwick, PA

All providers in Berwick, PA · Family Medicine Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.