Individual provider Active NPI

Joshua Ryan Mundorff, D.O.

  • Internal Medicine Physician
  • Wilkes Barre, PA
National Provider Identifier
1366738023
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS017136 Issued in PA
Practice address
1111 E End Blvd
Wilkes Barre, PA 18711-0026
Phone
(570) 824-3521
NPI assigned
Jun 21, 2011
Last updated
Apr 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS017136 PA Primary
Hospitalist Physician 208M00000X OS017136 PA

Addresses

Primary practice location

1111 E End Blvd
Wilkes Barre, PA 18711-0026

Mailing address

1111 E End Blvd
Wilkes Barre, PA 18711-0026
Phone (570) 824-3521

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140820001586 PA Practitioner - HospitalistPractitioner - Internal Medicine 2769600501 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Health Medical Group CurrentSince Jul 1, 2014 Accepting new patients
Tower Health Medical Group Internal Medicine Current Accepting new patients
Tower Health Medical Group CurrentSince Jul 1, 2014 Accepting new patients

Locations

301 S 7th Ave
Ste 130
West Reading, PA 19611
Phone (610) 988-4630

420 S 5th Ave
West Reading, PA 19611
Phone (484) 628-3637

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

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, 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": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1366738023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E END BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110026",
            "telephone_number": "570-824-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E END BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110026",
            "telephone_number": "570-824-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDORFF",
        "first_name": "JOSHUA",
        "middle_name": "RYAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-21",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS017136",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "OS017136",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.