Karina Geronilla Phang, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD469117 Issued in PA

Practice address

57 N Main St
Pittston, PA 18640-1915

Phone

(570) 602-5620

Fax

(570) 602-5621

NPI assigned

Apr 17, 2014

Last updated

May 10, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kphang233331@direct.geisinger.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Williamsport, PA
  • NPI 1376979534
  NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1215357256",
    "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": "178224903",
            "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": "57 N MAIN ST",
            "city": "PITTSTON",
            "state": "PA",
            "postal_code": "186401915",
            "telephone_number": "570-602-5620",
            "fax_number": "570-602-5621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42 N Main St",
            "address_purpose": "LOCATION",
            "city": "Pittston",
            "state": "PA",
            "postal_code": "186401916",
            "country_code": "US",
            "telephone_number": "570-654-0880",
            "fax_number": "570-655-9857",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "385 State St",
            "address_purpose": "LOCATION",
            "city": "Sunbury",
            "state": "PA",
            "postal_code": "178012531",
            "country_code": "US",
            "telephone_number": "570-286-6773",
            "fax_number": "570-286-7967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHANG",
        "first_name": "KARINA",
        "middle_name": "GERONILLA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-17",
        "last_updated": "2022-05-10",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "40774",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD469117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kphang233331@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "385 State St",
            "city": "Sunbury",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178012531",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kphang233331@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "57 N Main St",
            "city": "Pittston",
            "state": "PA",
            "country_code": "US",
            "postal_code": "186401915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patriotmed of Kansas, P.a.
• Brenda Ann Pavill, FNP, PH.D.
• Taylor Maria Pavlick
• Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy #02729)
• Kamakarra Perkins
• Pharmacy Corporation of America (PharMerica)
• Iesha T Phelps
• Physical Therapy Center Unlimited
• Ashley Elizabeth Pierson
• Jacqueline Rose Pinto, PTA

• Pediatrics Physician in Pittston, PA
• Providers in Pittston, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.