NPIMap

Individual provider Active NPI

Martin C Penetar, DO

  • Family Medicine Physician
  • South Abington Township, PA
National Provider Identifier
1366422230
Registry record updated Feb 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS006903L Issued in PA
Practice address
231 Northern Blvd
Suite 3
South Abington Township, PA 18411-9189
Phone
(570) 587-4113
Fax
(570) 587-7703
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS006903L PA Primary

Addresses

Primary practice location

231 Northern Blvd
Suite 3
South Abington Township, PA 18411-9189

Mailing address

231 Northern Blvd
Suite 3
South Abington Township, PA 18411-9189
Phone (570) 587-4113

Other identifiers 1

IdentifierTypeStateIssuer
001422917MedicaidPA

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
I20100607000309 PA Practitioner - Family Practice 2961585450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

231 Northern Blvd
Clarks Summit, PA 18411-9189
Phone (570) 586-4141

Hospital & facility affiliations

  • Traditional Home Health Care Home health agency, Dunmore, PA, CCN 397774
  • Geisinger-Community Medical Center Hospital, Scranton, PA, CCN 390001
  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270
  • Wilkes-Barre General Hospital Hospital, Wilkes-Barre, PA, CCN 390137
  • Regional Hospital of Scranton Hospital, Scranton, PA, CCN 390237
  • Lehigh Valley Hospital - Dickson City Hospital, Dickson City, PA, CCN 390338

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Family Medicine CurrentSince Oct 1, 2014 Accepting new patients
Geisinger Clinic Family Medicine Current Accepting new patients
Geisinger Clinic CurrentSince Oct 1, 2014 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

407 3rd Ave
Jessup, PA 18434
Phone (570) 383-7922

435 Scranton Carbondale Hwy
Scranton, PA 18508
Phone (570) 343-4334

231 Northern Blvd
South Abington Township, PA 18411
Phone (570) 585-8085

231 Northern Blvd
Ste 3
South Abington Township, PA 18411
Phone (570) 587-4113

Interoperability endpoints

  • Direct secure messaging: mpenetar@primemed.medentdirect.com

Organizations & group practices 4

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 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298332800000",
    "number": "1366422230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 NORTHERN BLVD",
            "address_2": "SUITE 3",
            "city": "SOUTH ABINGTON TOWNSHIP",
            "state": "PA",
            "postal_code": "184119189",
            "telephone_number": "570-587-4113",
            "fax_number": "570-587-7703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 NORTHERN BLVD",
            "address_2": "SUITE 3",
            "city": "SOUTH ABINGTON TOWNSHIP",
            "state": "PA",
            "postal_code": "184119189",
            "telephone_number": "570-587-4113",
            "fax_number": "570-587-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENETAR",
        "first_name": "MARTIN",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2011-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS006903L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001422917",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Abington Township, PA

Sources for this page

Verify at the official NPI Registry.