Active NPI
Madison Wivell
- Surgery Physician
- Wilkes Barre, PA
National Provider Identifier
1356137673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MT233703
- Practice address
- 1000 E Mountain Blvd
Wilkes Barre, PA 18711-0001 - Phone
- (570) 808-7300
- NPI assigned
- Apr 15, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MT233703 | PA | Primary |
Addresses
Primary practice location
1000 E Mountain Blvd
Wilkes Barre, PA 18711-0001
Mailing address
1000 E Mountain Blvd
Wilkes Barre, PA 18711-0001
Other practice location 1
1800 Mulberry St
Scranton, PA 18510-2369
Phone (570) 703-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250618000240 | PA | Order and Referring Only - General Surgery | 9830600667 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT233703 | PA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749513600000",
"number": "1356137673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 E MOUNTAIN BLVD",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "187110001"
},
{
"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": "187110001",
"telephone_number": "570-808-7300"
}
],
"practiceLocations": [
{
"address_1": "1800 Mulberry St",
"address_purpose": "LOCATION",
"city": "Scranton",
"state": "PA",
"postal_code": "185102369",
"country_code": "US",
"telephone_number": "570-703-8000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WIVELL",
"first_name": "MADISON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-15",
"last_updated": "2025-06-10",
"certification_date": "2025-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "PA",
"license": "MT233703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilkes Barre, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.