NPIMap

Individual provider Active NPI

Timothy J Storm, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Wilkes Barre, PA
National Provider Identifier
1346682937
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS039565 Issued in PA
Practice address
1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027
Phone
(570) 819-5626
NPI assigned
Jul 23, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS039565 PA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS039565 PA Primary

Addresses

Primary practice location

1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027

Mailing address

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

Other practice location 1

85 London Ln
Lewisburg, PA 17837-6516
Phone (570) 490-1660

Other practice location 2

85 London Ln
Lewisburg, PA 17837-6516
Phone (570) 490-1660

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tstorm109543@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
I20180612000006 PA Practitioner - Oral SurgeryPractitioner - Dentist 9537465752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

1000 E Mountain Dr
Wilkes Barre, PA 18711-0001
Phone (570) 826-7850

Hospital & facility affiliations

  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270
  • Geisinger-Community Medical Center Hospital, Scranton, PA, CCN 390001

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS039565PAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Oral and Maxillofacial Surgery CurrentSince Jul 2, 2018 Accepting new patients
Geisinger Clinic CurrentSince Jul 2, 2018 Accepting new patients
Geisinger Clinic Current Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300

1000 E Mountain Blvd
Wilkes Barre, PA 18711
Phone (570) 808-7399

Interoperability endpoints

  • Direct secure messaging: tstorm109543@direct.geisinger.edu

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 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1346682937",
    "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": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E MOUNTAIN BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110027",
            "telephone_number": "570-819-5626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "85 London Ln",
            "address_purpose": "LOCATION",
            "city": "Lewisburg",
            "state": "PA",
            "postal_code": "178376516",
            "country_code": "US",
            "telephone_number": "570-490-1660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "85 London Ln",
            "address_purpose": "LOCATION",
            "city": "Lewisburg",
            "state": "PA",
            "postal_code": "178376516",
            "country_code": "US",
            "telephone_number": "570-490-1660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STORM",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-23",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS039565",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS039565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tstorm109543@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1000 E Mountain Blvd",
            "city": "Wilkes Barre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187110027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.