Individual provider Active NPI

Ryan Seltzer, CRNP

  • Nurse Practitioner
  • Wilkes Barre, PA
National Provider Identifier
1417486572
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP017861 Issued in PA
Practice address
575 N River St
Wilkes Barre, PA 18764-5628
Phone
(570) 552-8800
NPI assigned
Jun 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP017861 PA Primary

Addresses

Primary practice location

575 N River St
Wilkes Barre, PA 18764-5628

Mailing address

624 Tioga Ave
Kingston, PA 18704-5628
Phone (570) 472-5554

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ryan.seltzer.2@21771.direct.athenahealth.com

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
I20171106000867 PA Practitioner - Nurse Practitioner 0244596310 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Physician Network LLCGroup PAC ID 2668696592, 63 clinicians

Practice addresses (Care Compare)

190 Welles St
Forty Fort, PA 18704-4968
Phone (570) 288-0400

4 E Main St
Nanticoke, PA 18634-1602
Phone (570) 735-7474

575 N River St
Wilkes Barre, PA 18702-2634
Phone (570) 552-8938

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.17 of 100Reported as apm
Quality
78.34
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pennsylvania Physician Services, LLC CurrentSince Jan 29, 2018 Accepting new patients
Commonwealth Physician Network LLC CurrentSince Nov 15, 2023 Accepting new patients
Pennsylvania Physician Services, LLC CurrentSince Jan 29, 2018 Accepting new patients

Locations

610 Wyoming Ave
#2
Kingston, PA 18704
Phone (570) 714-1032

610 Wyoming Ave
Kingston, PA 18704
Phone (570) 288-5441

4 E Main St
Nanticoke, PA 18634
Phone (570) 258-3939

575 N River St
Wilkes Barre, PA 18764
Phone (570) 552-1300

Organizations & group practices 3

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 2

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": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1417486572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 TIOGA AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045628",
            "telephone_number": "570-472-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 N RIVER ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187645628",
            "telephone_number": "570-552-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELTZER",
        "first_name": "RYAN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-12",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP017861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ryan.seltzer.2@21771.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "575 N River St",
            "city": "Wilkes Barre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187645628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.