Individual provider Active NPI

Edwin Nyamwaya Mogaka, MD

  • Family Medicine Physician
  • Tobyhanna, PA
National Provider Identifier
1417537655
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD484471 Issued in PA
Practice address
100 Community Dr
Tobyhanna, PA 18466-8985
Phone
(570) 895-2300
NPI assigned
Apr 12, 2021
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MT223964 PA
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X MD484471 PA Primary

Addresses

Primary practice location

100 Community Dr
Tobyhanna, PA 18466-8985

Mailing address

2100 Mack Blvd FL 4
Allentown, PA 18103-5622
Phone (484) 884-4500

Other practice location 1

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

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240825000074 PA Practitioner - Family Practice 8123423399 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD484471PAMDFamily Medicine Physician
MT223964PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Centers Inc. Family Medicine CurrentSince Aug 19, 2024 Accepting new patients
Lehigh Valley Physician Group CurrentSince Feb 21, 2025 Accepting new patients
Family Care Centers Inc Family Medicine CurrentSince Aug 19, 2024 Accepting new patients
Lehigh Valley Physician Group Family Medicine Current Accepting new patients
Lehigh Valley Physician Group Family Medicine CurrentSince Feb 21, 2025 Accepting new patients

Locations

2100 Mack Blvd
Fl 4
Allentown, PA 18103

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

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

320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240

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

Organizations & group practices 6

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 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": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1417537655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 4",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "484-884-4500"
        },
        {
            "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": "570-895-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 S Washington Ave Ste 1000",
            "address_purpose": "LOCATION",
            "city": "Scranton",
            "state": "PA",
            "postal_code": "185053814",
            "country_code": "US",
            "telephone_number": "570-343-2383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOGAKA",
        "first_name": "EDWIN",
        "middle_name": "NYAMWAYA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT223964",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD484471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tobyhanna, PA

Sources for this page

Verify at the official NPI Registry.