Mark William Bohn, M.D.

Primary specialty

Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X

License

MD025868E Issued in PA

Practice address

1020 W Lackawanna Ave
Scranton, PA 18504-2052

Phone

(570) 904-6000

Fax

(570) 871-4638

NPI assigned

Nov 12, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Mark William Bohn Professional name

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

Specialty

Family Practice

Education

Hahnemann University College of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cleanslate Medical Group of Pennsylvania LLCGroup PAC ID 8426334400, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Cleanslate Medical Group of Pennsylvania LLC

  • Multi-Specialty Clinic/Center
  • Wilkes Barre, PA
  • NPI 1184177263
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1255668125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 W LACKAWANNA AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185042052",
            "telephone_number": "570-904-6000",
            "fax_number": "570-871-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 W LACKAWANNA AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185042052",
            "telephone_number": "570-904-6000",
            "fax_number": "570-871-4638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHN",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-12",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD025868E",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "PA",
            "license": "MD025868E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "BOHN",
            "middle_name": "WILLIAM",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jamill Marcus Blue
• Jeffrey T Blum, MD
• Susan Marie Bochnovich Anderson, DPT
• Geetha Bodapati, MBBS
• Sarah Bodnar, LCSW
• Thomas S Boland, MD
• Jared Bomba
• Lori Bonafede
• Marie Susan Bonavoglia, PA-C
• Terri Lynn Bond, CDCES, NBC-HWC,

• Addiction Medicine (Preventive Medicine) Physician in Scranton, PA
• Providers in Scranton, PA by specialty
• Addiction Medicine (Preventive Medicine) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.