Individual provider Active NPI

Kristen Marie Mastrantoni, MD

  • Pediatrics Physician
  • Coal Township, PA
National Provider Identifier
1275113300
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD484879 Issued in PA
Practice address
4203 Hospital Rd
Coal Township, PA 17866-9668
Phone
(570) 644-2614
Fax
(570) 644-1618
NPI assigned
Apr 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD484879 PA Primary

Addresses

Primary practice location

4203 Hospital Rd
Coal Township, PA 17866-9668

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-5606

Other practice location 1

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-5606

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240703000922 PA Practitioner - Pediatric Medicine 2860894342 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Jul 1, 2024 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic Pediatrics CurrentSince Jul 1, 2024 Accepting new patients
Geisinger Medical Center Past Accepting new patients
Geisinger Clinic Pediatrics Past Accepting new patients
Geisinger Bloomsburg Hospital Past Accepting new patients

Locations

4200 Hospital Rd
Coal Township, PA 17866
Phone (570) 644-4200

4203 Hospital Rd
Coal Township, PA 17866
Phone (570) 486-4588

100 N Academy Ave
Danville, PA 17822

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1275113300",
    "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": "570-271-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4203 HOSPITAL RD",
            "city": "COAL TOWNSHIP",
            "state": "PA",
            "postal_code": "178669668",
            "telephone_number": "570-644-2614",
            "fax_number": "570-644-1618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 N Academy Ave",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "PA",
            "postal_code": "178229800",
            "country_code": "US",
            "telephone_number": "570-271-5606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASTRANTONI",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD484879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coal Township, PA

Sources for this page

Verify at the official NPI Registry.