NPIMap

Organization Active NPI

Department of Military Commonwealth of Pennsylvania

  • Skilled Nursing Facility
  • Scranton, PA
National Provider Identifier
1497734925
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
DEPARTMENT OF MILITARY COMMONWEALTH OF PENNSYLVANIA
Practice address
401 Penn Ave
Scranton, PA 18503
Phone
(570) 961-4353
Fax
(570) 961-4400
NPI assigned
Jan 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Authorized official

Name
Mr. Thomas Reed Jr.
Title
Fiscal Services Administrator
Phone
(814) 242-7789

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Military General Acute Care Hospital 2865M2000X
Nursing Facility/Intermediate Care Facility 313M00000X HP4183791 PA
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

401 Penn Ave
Scranton, PA 18503

Mailing address

401 Penn Avenue
Scranton, PA 18503
Phone (570) 961-4353

Other names 1

  • Gino J. Merli Veterans Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041007000372 PA Part B Supplier - Clinic/Group Practice 1557320348 Receives reassigned benefits from 24 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Erie, PA; Hollidaysburg, PA; Philadelphia, PA; Pittsburgh, PA; Scranton, PA; Spring City, PA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0887036Gino J Merli Veterans Center401 Penn Avenue, Scranton, PA 18503Certificate of waiverJun 2, 2028

National Provider Directory

National Provider Directory
Tax ID family
Ilhoon Kim12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653350400000",
    "number": "1497734925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 PENN AVENUE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "18503",
            "telephone_number": "570-961-4353",
            "fax_number": "570-961-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 PENN AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "18503",
            "telephone_number": "570-961-4353",
            "fax_number": "570-961-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF MILITARY COMMONWEALTH OF PENNSYLVANIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-12",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "FISCAL SERVICES ADMINISTRATOR",
        "authorized_official_telephone_number": "814-242-7789",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "2865M2000X",
            "taxonomy_group": "",
            "desc": "Military Hospital, Military General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "PA",
            "license": "HP4183791",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gino J. Merli Veterans Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gino J. Merli Veterans Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Scranton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.