NPIMap

Individual provider Active NPI

Christopher Alexander Demaioribus, MD

  • Vascular Surgery Physician
  • Wilkes Barre, PA
National Provider Identifier
1447310362
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD043896L Issued in PA
Practice address
1000 E Mountain Dr
Wilkes Barre, PA 18711-0027
Phone
(570) 808-6000
Fax
(570) 808-6061
NPI assigned
Dec 11, 2006
Last updated
Nov 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 41860 MN
Vascular Surgery Physician 2086S0129X MD043896L PA Primary

Addresses

Primary practice location

1000 E Mountain Dr
Wilkes Barre, PA 18711-0027

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
912327000MedicaidMN

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
I20220405000554 PA Practitioner - Vascular Surgery 8527073097 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Ohio State University College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

1000 E Mountain Dr
Wilkes Barre, PA 18711-0001
Phone (570) 826-7850

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD043896LPAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Apr 6, 2022 Accepting new patients
Geisinger Clinic CurrentSince Sep 19, 2022 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Sep 19, 2022 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince Apr 6, 2022 Accepting new patients
Geisinger Clinic Surgery Past Accepting new patients
Geisinger Wyoming Valley Medical Center Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300

950 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 808-3200

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

30 Monument Rd
Ste 1100
York, PA 17403
Phone (717) 851-2441

Interoperability endpoints

  • Direct secure messaging: cdemaioribus504323@direct.geisinger.edu

Organizations & group practices 8

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 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1447310362",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E MOUNTAIN DR",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110027",
            "telephone_number": "570-808-6000",
            "fax_number": "570-808-6061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMAIORIBUS",
        "first_name": "CHRISTOPHER",
        "middle_name": "ALEXANDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "41860",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "MD043896L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "912327000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.