Organization Active NPI

NE Pediatrics, Inc

  • Pediatrics Physician
  • Scranton, PA
National Provider Identifier
1316124902
Registry record updated Jan 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD009571E Issued in PA
Legal business name
NE PEDIATRICS, INC
Practice address
440 N Main Ave
Scranton, PA 18504-1720
Phone
(570) 347-5605
Fax
(570) 489-4583
NPI assigned
Jan 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2008

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

Authorized official

Name
Dr. Vincent L Ross, MDNPI 1104935808
Title
Physician
Phone
(570) 347-5605

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X MD009571E PA Primary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X MD063076L PA

Addresses

Primary practice location

440 N Main Ave
Scranton, PA 18504-1720

Mailing address

440 N Main Ave
Scranton, PA 18504-1720
Phone (570) 347-5605

Other identifiers 2

IdentifierTypeStateIssuer
361842OtherPABLUE SHIELD
1007577660001MedicaidPA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2313281NE Pediatrics Inc Vincent Ross440 N Main Ave, Scranton, PA 18504Certificate of waiverOct 28, 2026

National Provider Directory

National Provider Directory

Locations

440 N Main Ave
Scranton, PA 18504
Phone (570) 347-5605

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201219200000",
    "number": "1316124902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 N MAIN AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185041720",
            "telephone_number": "570-347-5605",
            "fax_number": "570-489-4583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 N MAIN AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185041720",
            "telephone_number": "570-347-5605",
            "fax_number": "570-489-4583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NE PEDIATRICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-25",
        "last_updated": "2008-01-25",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "570-347-5605",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD009571E",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD063076L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "361842",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007577660001",
            "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 Jan 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.