NPIMap

Individual provider Active NPI

Anthony Alan Wylie, D.O.

  • Family Medicine Physician
  • Pittston, PA
National Provider Identifier
1295992204
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS014176 Issued in PA
Practice address
300 Keystone Ave
Pittston, PA 18640-6153
Phone
(833) 552-1852
Fax
(570) 214-1525
NPI assigned
May 19, 2008
Last updated
Aug 5, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 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 OS014176 PA Primary

Addresses

Primary practice location

300 Keystone Ave
Pittston, PA 18640-6153

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1023187380001MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address awylie85521@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
I20090807000131 PA Practitioner - Family Practice 8123171212 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2006
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)

531 Mt Pleasant Dr
Scranton, PA 18503-1987
Phone (570) 342-8500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger-HM Joint Venture, LLC Family Medicine CurrentSince Aug 1, 2020 Accepting new patients
Geisinger-HM Joint Venture, LLC Family Medicine Current Accepting new patients
Geisinger Clinic Family Medicine CurrentSince Aug 9, 2020 Accepting new patients
Geisinger Clinic CurrentSince Nov 1, 2016 Accepting new patients
Geisinger Clinic Family Medicine Current Accepting new patients
Geisinger-HM Joint Venture LLC CurrentSince Aug 1, 2020 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

4004 Birney Ave
Moosic, PA 18507
Phone (570) 344-4711

300 Keystone Ave
Pittston, PA 18640
Phone (833) 552-1852

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

125 Scranton Pocono Hwy
Scranton, PA 18505
Phone (570) 342-8500

531 Mt Pleasant Dr
Scranton, PA 18503
Phone (570) 342-8500

1824 E 3rd St
Williamsport, PA 17701
Phone (570) 322-4422

Interoperability endpoints

  • Direct secure messaging: awylie85521@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1295992204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "address_2": "CREDENTIALS DEPT",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 KEYSTONE AVE",
            "city": "PITTSTON",
            "state": "PA",
            "postal_code": "186406153",
            "telephone_number": "833-552-1852",
            "fax_number": "570-214-1525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLIE",
        "first_name": "ANTHONY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-19",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS014176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023187380001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awylie85521@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "300 Keystone Ave",
            "city": "Pittston",
            "state": "PA",
            "country_code": "US",
            "postal_code": "186406153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittston, PA

Sources for this page

Verify at the official NPI Registry.