Individual provider Active NPI

John Rafferty, CRNP

  • Family Nurse Practitioner
  • Tobyhanna, PA
National Provider Identifier
1386294684
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP020602 Issued in PA
Practice address
100 Community Dr
Tobyhanna, PA 18466-8985
Phone
(570) 839-1400
Fax
(570) 839-1079
NPI assigned
Sep 18, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN684876 PA
Family Nurse Practitioner 363LF0000X SP020602 PA Primary

Addresses

Primary practice location

100 Community Dr
Tobyhanna, PA 18466-8985

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311
Phone (484) 884-4500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191213001462 PA Practitioner - Nurse Practitioner 7810320355 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

100 Community Dr
Suite 102
Tobyhanna, PA 18466-8986
Phone (570) 839-8754

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

200 E Brown St
LVPG Family Medicine Esu
East Stroudsburg, PA 18301-3006
Phone (272) 762-4378

384 Airport Rd
Hazle Township, PA 18202-3325
Phone (570) 861-8717

5649 Wynnewood Dr
Laurys Station, PA 18059-1124

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.09 of 100Reported as group
Quality
74.47
Promoting interoperability
86
Improvement activities
40
Cost
74.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN684876PAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Centers Inc. Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2025 Accepting new patients
Schuylkill Health System Medical Group, Inc. CurrentSince Nov 13, 2023 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2025 Accepting new patients
Schuylkill Health System Medical Group, Inc. Family CurrentSince Nov 13, 2023 Accepting new patients
Family Care Centers Inc CurrentSince Dec 30, 2019 Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

2100 Mack Blvd
Allentown, PA 18103
Phone (484) 224-1892

120 Burrus Blvd
Brodheadsville, PA 18322
Phone (570) 402-6101

500 Plaza Ct
Ste A
East Stroudsburg, PA 18301
Phone (570) 424-9970

200 E Brown St
East Stroudsburg, PA 18301
Phone (570) 476-3700

500 Plaza Ct
East Stroudsburg, PA 18301
Phone (570) 426-2330

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

200 Schuylkill Medical Plz
Pottsville, PA 17901
Phone (570) 621-9200

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

100 Community Dr
Tobyhanna, PA 18466
Phone (570) 424-2100

100 Community Dr
Ste 102
Tobyhanna, PA 18466
Phone (570) 839-8754

Organizations & group practices 9

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1568764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1386294684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COMMUNITY DR",
            "city": "TOBYHANNA",
            "state": "PA",
            "postal_code": "184668985",
            "telephone_number": "570-839-1400",
            "fax_number": "570-839-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFFERTY",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-18",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN684876",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP020602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tobyhanna, PA

Sources for this page

Verify at the official NPI Registry.