NPIMap

Individual provider Active NPI

Michael Robert Kapottos, DO

  • Internal Medicine Physician
  • Tunkhannock, PA
National Provider Identifier
1417453036
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS021307 Issued in PA
Practice address
10 Trieble Dr
Tunkhannock, PA 18657-7054
Phone
(570) 996-2700
Fax
(570) 996-2711
NPI assigned
Apr 3, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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 OS021307 PA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

10 Trieble Dr
Tunkhannock, PA 18657-7054

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

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
I20210713001749 PA Practitioner - Internal Medicine 1456699057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Liberty Univ College of Osteopathic Medicine, 2018
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

Practice addresses (Care Compare)

10 Trieble Dr
Tunkhannock, PA 18657-7054
Phone (570) 996-2700

Hospital & facility affiliations

  • Homebound Health Services Inc Home health agency, Dallas, PA, CCN 397486
  • Traditional Home Health Care Home health agency, Dunmore, PA, CCN 397774
  • Interim Healthcare Services of NE PA, Inc. Home health agency, Blakely, PA, CCN 397477
  • Associated Family Home Care, Inc. Home health agency, Kingston, PA, CCN 397502
  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270
  • Geisinger-Community Medical Center Hospital, Scranton, PA, CCN 390001
  • Geisinger Medical Center Hospital, Danville, PA, CCN 390006

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Aug 1, 2021 Accepting new patients
Geisinger Clinic CurrentSince Aug 1, 2021 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

809 Hunter Hwy
Tunkhannock, PA 18657
Phone (570) 966-2700

10 Trieble Dr
Tunkhannock, PA 18657
Phone (570) 836-2273

Interoperability endpoints

  • Direct secure messaging: mkapottos464737@direct.geisinger.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 60

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

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1417453036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 TRIEBLE DR",
            "city": "TUNKHANNOCK",
            "state": "PA",
            "postal_code": "186577054",
            "telephone_number": "570-996-2700",
            "fax_number": "570-996-2711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPOTTOS",
        "first_name": "MICHAEL",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS021307",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tunkhannock, PA

Sources for this page

Verify at the official NPI Registry.