NPIMap

Individual provider Active NPI

Leocadia T Prawdzik, MD

  • Internal Medicine Physician
  • Hazleton, PA
National Provider Identifier
1346218104
Registry record updated Dec 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD039665L Issued in PA
Practice address
1090 N Church St
Hazleton, PA 18202-1446
Phone
(570) 459-1485
Fax
(570) 459-6354
NPI assigned
Mar 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD039665L PA Primary

Addresses

Primary practice location

1090 N Church St
Hazleton, PA 18202-1446

Mailing address

1090 N Church St
Hazleton, PA 18202-1446
Phone (570) 459-1485

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
I20100924000772 PA Practitioner - Internal Medicine 2668554775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Internal Medicine Assoc of Hazelton IncGroup PAC ID 5193708816, 3 clinicians

Practice addresses (Care Compare)

1090 N Church St
Hazle Township, PA 18202-1480
Phone (570) 459-1485

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD039665LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Assoc of Hazelton Inc Internal Medicine CurrentSince Oct 9, 1986 Accepting new patients
Mountain City Nursing & Rehabilitation Center, LLC Past Accepting new patients
Manor at St. Luke Village Facility Operations, LLC Past Accepting new patients

Locations

607 Centre St
Freeland, PA 18224
Phone (570) 579-8300

1090 N Church St
Hazle Township, PA 18202
Phone (570) 459-1485

403 Hazle Township Blvd
Hazle Township, PA 18202
Phone (570) 454-8888

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 61

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

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261008000000",
    "number": "1346218104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 N CHURCH ST",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182021446",
            "telephone_number": "570-459-1485",
            "fax_number": "570-459-6354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 N CHURCH ST",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182021446",
            "telephone_number": "570-459-1485",
            "fax_number": "570-459-6354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRAWDZIK",
        "first_name": "LEOCADIA",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2009-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD039665L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazleton, PA

Sources for this page

Verify at the official NPI Registry.