Individual provider Active NPI

Gary Allan Hrobuchak, DPM

  • Podiatrist
  • Blakeslee, PA
National Provider Identifier
1366505174
Registry record updated Dec 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC004304L Issued in PA
Practice address
395 Route 940
Suite 105
Blakeslee, PA 18610-0007
Phone
(570) 643-1398
Fax
(570) 646-4448
NPI assigned
Dec 19, 2006
Last updated
Dec 2, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC004304L PA Primary

Addresses

Primary practice location

395 Route 940
Suite 105
Blakeslee, PA 18610-0007

Mailing address

Route 940 PO Box 7
Blakeslee, PA 18610-0007
Phone (570) 643-1398

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050119000662 PA Practitioner - Podiatry 3274582077 Reassigns benefits to 1 organization
Practice locations: Blakeslee, PA; Carbondale, PA; Dunmore, PA
O20100930059812 PA DME Supplier - Physician - Podiatry 4486844495 Practice locations: Blakeslee, PA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samuel Ganz MD PLLCGroup PAC ID 8820521248, 3 clinicians

Practice addresses (Care Compare)

500 W Hospital St
Taylor, PA 18517-2012
Phone (570) 562-2102

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue49
Removal of nail tissue1905
Removal or shaving of skin growth771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC004304LPAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel Ganz MD PLLC CurrentSince Dec 1, 2024 Accepting new patients
Laporta and Associates,PC Podiatrist Past Accepting new patients
Regional Foot & Ankle Center PC Podiatrist PastSince Nov 30, 2021 Accepting new patients
Fred Lombardo, PC Podiatrist Past Accepting new patients

Locations

500 W Hospital St
Taylor, PA 18517
Phone (570) 483-8450

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322784000000",
    "number": "1366505174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ROUTE 940 PO BOX 7",
            "city": "BLAKESLEE",
            "state": "PA",
            "postal_code": "186100007",
            "telephone_number": "570-643-1398",
            "fax_number": "570-646-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 ROUTE 940",
            "address_2": "SUITE 105",
            "city": "BLAKESLEE",
            "state": "PA",
            "postal_code": "186100007",
            "telephone_number": "570-643-1398",
            "fax_number": "570-646-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HROBUCHAK",
        "first_name": "GARY",
        "middle_name": "ALLAN",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2011-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC004304L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blakeslee, PA

Sources for this page

Verify at the official NPI Registry.