NPIMap

Individual provider Active NPI

Edward Thomas O'Brien, M.D.

  • Medical Oncology Physician
  • Selinsgrove, PA
National Provider Identifier
1205808276
Registry record updated Dec 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
MD024174E Issued in PA
Practice address
1575 N Old TRL
Selinsgrove, PA 17870-8381
Phone
(570) 374-8555
Fax
(570) 374-9933
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X MD024174E PA Primary
Medical Oncology Physician 207RX0202X 235282-1 NY

Addresses

Primary practice location

1575 N Old TRL
Selinsgrove, PA 17870-8381

Mailing address

1575 N Old TRL
Selinsgrove, PA 17870-8381
Phone (570) 374-8555

Other identifiers 5

IdentifierTypeStateIssuer
00949440MedicaidNY
CC9269OtherPARR MEDICARE GROUP
GU039841OtherPAPA MEDICARE GROUP
0010399860010MedicaidPA
P00127810OtherPARR MEDICARE PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040623000160 PA Practitioner - Medical Oncology 2860477809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
Georgetown University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

55 Medical Park Dr
Lewisburg, PA 17837-6343
Phone (570) 523-3264

75 Medical Park Dr
Lewisburg, PA 17837-6343
Phone (570) 523-9200

Hospital & facility affiliations

  • Geisinger Medical Center Hospital, Danville, PA, CCN 390006
  • Wellspan Evangelical Community Hospital Hospital, Lewisburg, PA, CCN 390013
  • Geisinger Jersey Shore Hospital Hospital, Jersey Shore, PA, CCN 391300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
235282-1NYMDMedical Oncology Physician
MD024174EPAMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Oct 1, 2014 Accepting new patients
Geisinger Clinic CurrentSince Oct 1, 2014 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

75 Medical Park Dr
Lewisburg, PA 17837
Phone (570) 374-8555

1575 N Old Trl
Selinsgrove, PA 17870
Phone (570) 374-8555

Organizations & group practices 4

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.

Hospital & facility affiliations 29

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387497600000",
    "number": "1205808276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 N OLD TRL",
            "city": "SELINSGROVE",
            "state": "PA",
            "postal_code": "178708381",
            "telephone_number": "570-374-8555",
            "fax_number": "570-374-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 N OLD TRL",
            "city": "SELINSGROVE",
            "state": "PA",
            "postal_code": "178708381",
            "telephone_number": "570-374-8555",
            "fax_number": "570-374-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "EDWARD",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2013-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "PA",
            "license": "MD024174E",
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NY",
            "license": "235282-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00949440",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "CC9269",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA MEDICARE GROUP",
            "identifier": "GU039841",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010399860010",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "P00127810",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Selinsgrove, PA

Sources for this page

Verify at the official NPI Registry.