NPIMap

Individual provider Active NPI

Konstantinos Damiris, DO

  • Student in an Organized Health Care Education/Training Program
  • Newark, NJ
National Provider Identifier
1366901183
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
150 Bergen St
Newark, NJ 07103-2496
Phone
(516) 236-1620
NPI assigned
Mar 19, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

150 Bergen St
Newark, NJ 07103-2496

Mailing address

3 Warwick Blvd
Island Park, NY 11558-1801
Phone (516) 236-1620

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
I20250724000257 PA Practitioner - Internal Medicine 1254712896 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2019
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
Geisinger-HM Joint Venture LLCGroup PAC ID 1355676370, 426 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6211

255 Route 220 Hwy
Muncy, PA 17756-7569
Phone (570) 308-2600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy70
Upper gastrointestinal (GI) endoscopy for acid reflux45

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Jul 1, 2025 Accepting new patients
Geisinger-HM Joint Venture, LLC CurrentSince Jul 1, 2025 Accepting new patients
Geisinger-HM Joint Venture, LLC CurrentSince Jul 1, 2025 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Jul 1, 2025 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

4200 Hospital Rd
Coal Township, PA 17866
Phone (570) 644-4200

16 Woodbine Ln
Danville, PA 17821
Phone (570) 271-6531

100 N Academy Ave
Danville, PA 17822

1020 Thompson St
Jersey Shore, PA 17740
Phone (570) 398-0100

310 Electric Ave
Lewistown, PA 17044
Phone (717) 242-2531

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

255 Route 220 Hwy
Muncy, PA 17756
Phone (570) 308-2600

1201 Oak St
Pittston, PA 18640
Phone (570) 808-9800

132 Abigail Ln
Port Matilda, PA 16870
Phone (814) 272-5011

1800 Mulberry St
Scranton, PA 18510
Phone (570) 703-7351

675 Baltimore Dr
Wilkes Barre, PA 18702
Phone (570) 808-5757

Organizations & group practices 6

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 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1366901183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WARWICK BLVD",
            "city": "ISLAND PARK",
            "state": "NY",
            "postal_code": "115581801",
            "telephone_number": "516-236-1620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032496",
            "telephone_number": "516-236-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMIRIS",
        "first_name": "KONSTANTINOS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.