Active NPI
Neurosurgical Specialties of Nepa
- Neurological Surgery Physician
- Wilkes Barre, PA
National Provider Identifier
1376723767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- MD038409E
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0013958830003 | Medicaid | PA |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Neurological Surgery Physician
- Gulfport, MS
- NPI 1811084171
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.