Ketevan Gvalia, M. D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01079486A Issued in IN

Practice address

1800 Mulberry St
Scranton, PA 18510-2369

Phone

(570) 703-7351

Fax

(570) 703-7801

NPI assigned

Apr 16, 2013

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

Other names 1

• Ketevan Friedkin Other name

Medicare fee-for-service enrollment

Enrolled in IN, PA2 enrollments

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 2

Specialty

Internal Medicine

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Arnett Clinic LLCGroup PAC ID 0749184380, 401 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indiana University Health Arnett Hospital Hospital, Lafayette, IN, CCN 150173
• Indiana University Health Hospital, Indianapolis, IN, CCN 150056
• Indiana University Health White Memorial Hospital Hospital, Monticello, IN, CCN 151312

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Arnett Clinic, LLC

  • Internal Medicine Physician
  • Lafayette, IN
  • NPI 1164490843
  Medicare reassignment Care Compare group NPD
• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777
  Medicare reassignment Care Compare group NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment NPD
• Baptist Health Medical Group Inc

  • Urgent Care Clinic/Center
  • Louisville, KY
  • NPI 1508269200

  IN

  Medicare reassignment NPD
• Northwest Hospitalist Physicians, LLP

  • Emergency Medicine Physician
  • Bloomington, IN
  • NPI 1023448321
  Medicare reassignment NPD
• Geisinger Clinic

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

  • Family Medicine Physician
  • Jessup, PA
  • NPI 1962819532
  NPD
• Arnett Clinic, LLC

  • Durable Medical Equipment & Medical Supplies
  • Lafayette, IN
  • NPI 1699839563
  NPD
• Arnett Clinic, LLC

  • Clinical Medical Laboratory
  • Lafayette, IN
  • NPI 1881655090
  NPD
• Baptist Health Medical Group Inc

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1780961300
  NPD
• Baptist Health Medical Group Inc

  • Rural Health Clinic/Center
  • Dawson Springs, KY
  • NPI 1982178216
  NPD
• Northwest Hospitalist Physicians LLP

  • Hospitalist Physician
  • La Porte, IN
  • NPI 1326415423
  NPD

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

• Indiana University Health Arnett Inc

  • General Acute Care Hospital
  • Lafayette, IN
  • NPI 1326296211
  Care Compare affiliation
• Indiana University Health Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1144266024
  Care Compare affiliation
• Indiana University Health White Memorial Hospital Inc

  • Critical Access Hospital
  • Monticello, IN
  • NPI 1710983945
  Care Compare affiliation

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

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1255774527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MULBERRY ST",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185102369",
            "telephone_number": "570-703-7351",
            "fax_number": "570-703-7801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5165 McCarty Ln",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479058764",
            "country_code": "US",
            "telephone_number": "765-448-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GVALIA",
        "first_name": "KETEVAN",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-16",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "TMD005308",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01079486A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01079486A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KETEVAN",
            "last_name": "FRIEDKIN",
            "credential": "M. D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Vishaal Gupta, MD
• Jazmine Kaur Gurm
• Nicholas James Gurski
• John Robert Guzek, MD
• Elyse Christianna Guziewicz
• William Michael Haas, DO
• Michele Hadley I, CRNP
• Chelsea Hafner
• Dorothy Marie Hagan, LCSW
• Christine Haggerty, REGISTERED NURSE

• Internal Medicine Physician in Scranton, PA
• Providers in Scranton, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.