NPIMap

Individual provider Active NPI

Edward Dzielak, DO

  • Geriatric Medicine (Internal Medicine) Physician
  • Jermyn, PA
National Provider Identifier
1386611440
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
OS004141L Issued in PA
Practice address
5 S Washington Ave
Jermyn, PA 18433-1121
Phone
(570) 230-0019
NPI assigned
Mar 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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 OS004141L PA
Geriatric Medicine (Internal Medicine) Physician 207RG0300X OS004141L PA Primary

Addresses

Primary practice location

5 S Washington Ave
Jermyn, PA 18433-1121

Mailing address

501 S Washington Ave Ste 1000
Scranton, PA 18505-3814
Phone (570) 343-2383

Other identifiers 1

IdentifierTypeStateIssuer
000834808MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address edwardd@thewrightcenter.medentdirect.com Direct

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
I20100317000163 PA Practitioner - Internal Medicine 5092737114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Wright Center Medical GroupGroup PAC ID 6305841230, 38 clinicians

Practice addresses (Care Compare)

5 S Washington Ave
Jermyn, PA 18433-1121
Phone (570) 230-0019

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Wright Center Medical Group Internal Medicine CurrentSince Jan 27, 2020 Accepting new patients
The Wright Center Medical Group Internal Medicine CurrentSince Jan 27, 2020 Accepting new patients
The Corvallis Clinic P C Past Accepting new patients
Physicians Health Alliance Inc Past Accepting new patients

Locations

260 Daleville Hwy
Ste 103
Covington Township, PA 18444
Phone (570) 591-5150

103 Spruce St
Hawley, PA 18428
Phone (570) 390-4545

1855 Fair Ave
Lowr
Honesdale, PA 18431
Phone (570) 253-3980

5 S Washington Ave
Jermyn, PA 18433
Phone (570) 230-0019

1401 Fellows St
Scranton, PA 18504
Phone (570) 591-5280

501 S Washington Ave
Ste 1000
Scranton, PA 18505
Phone (570) 866-3058

200 Wyoming Ave
#250
Scranton, PA 18503
Phone (570) 342-5253

312 Boulevard Ave
Scranton, PA 18519
Phone (570) 489-4567

329 Cherry St
Ste 1B
Scranton, PA 18505
Phone (570) 591-5250

1145 Northern Blvd
South Abington Township, PA 18411
Phone (570) 493-1335

169 N Pennsylvania Ave
Wilkes Barre, PA 18701
Phone (570) 346-8147

Interoperability endpoints

  • Direct secure messaging: edwardd@thewrightcenter.medentdirect.com
  • FHIR API: https://api.platform.athenahealth.com/14349/brand/4/csg/42/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 10

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": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1386611440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S WASHINGTON AVE STE 1000",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185053814",
            "telephone_number": "570-343-2383",
            "fax_number": "570-343-3923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 S WASHINGTON AVE",
            "city": "JERMYN",
            "state": "PA",
            "postal_code": "184331121",
            "telephone_number": "570-230-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIELAK",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS004141L",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "PA",
            "license": "OS004141L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000834808",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edwardd@thewrightcenter.medentdirect.com",
            "affiliation": "N",
            "endpointDescription": "HISP",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "5 S Washington Ave",
            "city": "Jermyn",
            "state": "PA",
            "country_code": "US",
            "postal_code": "184331121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jermyn, PA

Sources for this page

Verify at the official NPI Registry.