Organization Active NPI

St. Joseph's Center

Intellectual Disabilities Intermediate Care Facility
Scranton, PA

National Provider Identifier

1316075419

Registry record updated Jun 16, 2008

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
Practitioners & affiliated clinicians
NPI Registry JSON
Other providers in Scranton, PA
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name: ST. JOSEPH'S CENTER
Practice address: 2010 Adams Ave
Scranton, PA 18509-1508
Phone: (570) 342-8379
Fax: (570) 963-1286
NPI assigned: Mar 1, 2007
Last updated: Jun 16, 2008By the provider in NPPES
Organization subpart: No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name: Robert Gordon
Title: Vice President Cfo
Phone: (570) 963-1273

Specialties & licenses 10

Specialty (taxonomy)	Code	State	Primary
Developmentally Disabled Services Day Training Agency	251C00000X	NU
Home Health Agency	251E00000X	PA
Intellectual Disabilities Intermediate Care Facility	315P00000X	PA	Primary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	320900000X	PA
Child Intellectual and/or Developmental Disabilities Respite Care	385HR2060X	PA
Physical Therapist	225100000X	PA
Recreation Therapist	225800000X	PA
Music Therapist	225A00000X	PA
Occupational Therapist	225X00000X	PA
Speech-Language Pathologist	235Z00000X	PA

Addresses

Primary practice location

2010 Adams Ave
Scranton, PA 18509-1508

Mailing address

2010 Adams Ave
Scranton, PA 18509-1508
Phone (570) 342-8379

Other identifiers 20

Identifier	Type	State	Issuer
1000013880038	Medicaid	PA
1000013880057	Medicaid	PA
1000013880034	Medicaid	PA
1576764PT	Other	PA	HIGHMARK BLUE SHIELD
1000013880040	Medicaid	PA
1000013880047	Medicaid	PA
1576770ST	Other	PA	HIGHMARK BLUE SHIELD
1000013880031	Medicaid	PA
1000013880055	Medicaid	PA
1000013880059	Medicaid	PA
1000013880061	Medicaid	PA
1000013880063	Medicaid	PA
1000013880001	Medicaid	PA
1000013880050	Medicaid	PA
1000013880058	Medicaid	PA
1000013880046	Medicaid	PA
1000013880049	Medicaid	PA
1000013880048	Medicaid	PA
1000013880054	Medicaid	PA
1000013880056	Medicaid	PA

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment: Enrolled in PA

Enrollment records 1

Enrollment ID	State	Provider type	PAC ID	Details
O20090914000490	PA	Part B Supplier - Clinic/Group Practice	2668527912	Receives reassigned benefits from 6 practitioners Practice locations: Dunmore, PA; Scranton, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316075419. Details of each certification follow.

CCN 39G033 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 39G033

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name: ST JOSEPH'S CENTER SCRANTON
Certification status: Active
Provider type (POS): Intermediate care facility for individuals with intellectual disabilities
Participating since: Feb 1, 1983
Last certification: Oct 6, 2025
Beds: 88
Ownership / control type: Private (non-profit)
Facility address: 2010 Adams Ave
Scranton, PA 18509

National Provider Directory

Locations

1401 Monroe Ave
Scranton, PA 18509
Phone (570) 963-1278

1401 Monroe Ave
Ste 1
Scranton, PA 18509

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Christopher D Brozena, DPT
- Physical Therapist
- Scranton, PA
- NPI 1083064752
Medicare reassignment Care Compare group NPD
Mariah Frances Hawley
- Physical Rehabilitation Occupational Therapist
- Scranton, PA
- NPI 1336935667
Medicare reassignment Care Compare group NPD
Michael Thomas Kane, PT
- Physical Therapist
- Scranton, PA
- NPI 1083707186
Medicare reassignment Care Compare group NPD
Jennifer A Barillo, OT
- Occupational Therapist
- Lake Ariel, PA
- NPI 1316930829
Medicare reassignment NPD
Karen Lynn Kane, MPT
- Pediatric Physical Therapist
- Clarks Summit, PA
- NPI 1578642534
Medicare reassignment NPD
Nadia Lucas, M.S., CFY-SLP
- Speech-Language Pathologist
- Plains TWP, PA
- NPI 1003217969
Medicare reassignment NPD
Kathleen Klatt, SLP
- Speech-Language Pathologist
- Scranton, PA
- NPI 1164208104
NPD
Kathleen Taylor, COMMUNICATION SPEC
- Interpreter
- Scranton, PA
- NPI 1629610043
NPD
Charles Carter Anderson, PT
- Physical Therapist
- Scranton, PA
- NPI 1669565792
NPD (past)
Frank W Carey
- Music Therapist
- Scranton, PA
- NPI 1023515368
NPD (past)
Jacquelyn Elizabeth Comerford, OT
- Occupational Therapist
- Scranton, PA
- NPI 1689761397
NPD (past)
Ashley Nicole Grevera, MS, OTR/L, RYT
- Occupational Therapist
- Hunlock Creek, PA
- NPI 1932676285
NPD (past)

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1316075419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 ADAMS AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185091508",
            "telephone_number": "570-342-8379",
            "fax_number": "570-963-1286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 ADAMS AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185091508",
            "telephone_number": "570-342-8379",
            "fax_number": "570-963-1286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH'S CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "VICE PRESIDENT CFO",
        "authorized_official_telephone_number": "570-963-1273"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "PA",
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "225A00000X",
            "taxonomy_group": "",
            "desc": "Music Therapist",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
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            "code": "05",
            "desc": "MEDICAID",
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        },
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            "identifier": "1000013880034",
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        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1576764PT",
            "state": "PA"
        },
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            "code": "05",
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        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1576770ST",
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        {
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            "desc": "MEDICAID",
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            "identifier": "1000013880054",
            "state": "PA"
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        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000013880056",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.