Organization Active NPI

Neurosurgical Specialties of Nepa

  • Neurological Surgery Physician
  • Wilkes Barre, PA
National Provider Identifier
1376723767
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
MD038409E Issued in PA
Legal business name
NEUROSURGICAL SPECIALTIES OF NEPA
Practice address
150 Mundy Street
Mac 4
Wilkes Barre, PA 18702
Phone
(570) 823-3300
Fax
(570) 823-0800
NPI assigned
Nov 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Authorized official

Name
Mr. David J Sedor, MD
Title
President
Phone
(570) 823-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X MD038409E PA Primary

Addresses

Primary practice location

150 Mundy Street
Mac 4
Wilkes Barre, PA 18702

Mailing address

150 Mundy Street
Mac 4
Wilkes Barre, PA 18702
Phone (570) 823-3300

Other identifiers 1

IdentifierTypeStateIssuer
0013958830003MedicaidPA

National Provider Directory

National Provider Directory

Locations

150 Mundy St
#111
Wilkes Barre, PA 18702

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1376723767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MUNDY STREET",
            "address_2": "MAC 4",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "18702",
            "telephone_number": "570-823-3300",
            "fax_number": "570-823-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MUNDY STREET",
            "address_2": "MAC 4",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "18702",
            "telephone_number": "570-823-3300",
            "fax_number": "570-823-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROSURGICAL SPECIALTIES OF NEPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "SEDOR",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-823-3300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": "PA",
            "license": "MD038409E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0013958830003",
            "state": "PA"
        }
    ],
    "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 Nov 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.