Active NPI
Geisinger Clinic
- Radiation Oncology Physician
- Wilkes Barre, PA
National Provider Identifier
1285686105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- Legal business name
- GEISINGER CLINIC
- Practice address
- 1000 E Mountain Dr
Wilkes Barre, PA 18711 - Phone
- (570) 826-7300
- NPI assigned
- May 17, 2006
- Last updated
- Mar 31, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Cindy L Mull
- Title
- System Director Enrollments
- Phone
- (570) 271-6603
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | Primary |
Addresses
Primary practice location
1000 E Mountain Dr
Wilkes Barre, PA 18711
Mailing address
100 N Academy Ave
Danville, PA 17822-3034
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040130000518 | PA | Part B Supplier - Clinic/Group Practice | 5395657001 |
Receives reassigned benefits from 5,323 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider Directory- Tax ID family
- Geisinger Medical Oncology Lock Haven
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This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1585612800000",
"number": "1285686105",
"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": "178223034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 E MOUNTAIN DR",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "18711",
"telephone_number": "570-826-7300"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GEISINGER CLINIC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-17",
"last_updated": "2020-03-31",
"certification_date": "2020-03-31",
"status": "A",
"authorized_official_last_name": "MULL",
"authorized_official_first_name": "CINDY",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "SYSTEM DIRECTOR ENROLLMENTS",
"authorized_official_telephone_number": "570-271-6603"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Radiation Oncology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wilkes Barre, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.