NPIMap

Individual provider Active NPI

Millicent Owusu Tiwaah, DO

  • Family Medicine Physician
  • Dallas, PA
National Provider Identifier
1235457615
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS017197 Issued in PA
Practice address
114 LT Michael Cleary Dr
Dallas, PA 18612-1649
Phone
(570) 675-2000
Fax
(570) 675-1806
NPI assigned
May 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS017197 PA Primary

Addresses

Primary practice location

114 LT Michael Cleary Dr
Dallas, PA 18612-1649

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mtiwaah235521@direct.geisinger.edu Direct

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
I20141002001831 PA Practitioner - Family Practice 2567689466 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2010
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)

560 Pierce St
Kingston, PA 18704-5716
Phone (570) 283-2161

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS017197PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scranton Quincy Clinic Company LLC Family Medicine CurrentSince Sep 1, 2014 Accepting new patients
Geisinger Clinic Family Medicine Current Accepting new patients
Scranton Quincy Clinic Company LLC CurrentSince Sep 1, 2014 Accepting new patients
Geisinger Clinic Family Medicine CurrentSince Mar 2, 2020 Accepting new patients
Geisinger Clinic CurrentSince Mar 2, 2020 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

150 Brooklyn St
Carbondale, PA 18407
Phone (570) 282-2031

114 Lt Michael Cleary Dr
Dallas, PA 18612
Phone (570) 255-1178

100 N Academy Ave
Danville, PA 17822

560 Pierce St
Kingston, PA 18704
Phone (570) 283-2161

12 Kirby Ave
Mountain Top, PA 18707
Phone (570) 474-5978

315 S Main St
Old Forge, PA 18518
Phone (570) 457-8364

1400 Main St
Peckville, PA 18452
Phone (570) 307-7600

57 N Main St
Pittston, PA 18640
Phone (570) 602-5620

Interoperability endpoints

  • Direct secure messaging: mtiwaah235521@direct.geisinger.edu

Organizations & group practices 6

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 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1273536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1235457615",
    "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": "114 LT MICHAEL CLEARY DR",
            "city": "DALLAS",
            "state": "PA",
            "postal_code": "186121649",
            "telephone_number": "570-675-2000",
            "fax_number": "570-675-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIWAAH",
        "first_name": "MILLICENT",
        "middle_name": "OWUSU",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-11",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS017197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mtiwaah235521@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "114 Lt Michael Cleary Dr",
            "city": "Dallas",
            "state": "PA",
            "country_code": "US",
            "postal_code": "186121649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, PA

Sources for this page

Verify at the official NPI Registry.