Active NPI
Edward Joseph Kloniecke III, M.D.
- Urology Physician
- Pittston, PA
National Provider Identifier
1538693676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- MD481135
- Practice address
- 1201 Oak St
Pittston, PA 18640-3798 - Phone
- (570) 808-9800
- Fax
- (570) 808-9801
- NPI assigned
- Apr 15, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | MD481135 | PA | Primary |
| Urology Physician | 208800000X | MT214398 | PA |
Addresses
Primary practice location
1201 Oak St
Pittston, PA 18640-3798
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: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1201 Oak St
Pittston, PA 18640-3798
Phone (570) 808-9800
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 15 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD481135 | PA | MD | Urology Physician |
| MT214398 | PA | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Geisinger Clinic | Current | Accepting new patients | |
| Geisinger Clinic | Current | Accepting new patients | |
| Geisinger Clinic | Current | Accepting new patients | |
| Geisinger Clinic | Past | Accepting new patients |
Locations
100 N Academy Ave
Danville, PA 17822
1201 Oak St
Pittston, PA 18640
Phone (570) 808-9800
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.
-
- Family Medicine Physician
- Danville, PA
- NPI 1366493868
-
- Diagnostic Radiology Physician
- Danville, PA
- NPI 1558313023
-
- Pediatrics Physician
- Lewisburg, PA
- NPI 1861048803
-
- Hospitalist Physician
- Wilkes Barre, PA
- NPI 1588614358
Hospital & facility affiliations 56
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Endocrinology, Diabetes & Metabolism Physician
- Scranton, PA
- NPI 1306439856
Hospital
-
- General Acute Care Hospital
- Scranton, PA
- NPI 1366444507
-
- General Acute Care Hospital
- Scranton, PA
- NPI 1972652063
-
- General Acute Care Hospital
- Danville, PA
- NPI 1013384809
-
- General Acute Care Hospital
- Coal Township, PA
- NPI 1033491741
-
- Psychiatric Hospital Unit
- Danville, PA
- NPI 1144301102
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697760000000",
"number": "1538693676",
"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": "1201 OAK ST",
"city": "PITTSTON",
"state": "PA",
"postal_code": "186403798",
"telephone_number": "570-808-9800",
"fax_number": "570-808-9801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLONIECKE",
"first_name": "EDWARD",
"middle_name": "JOSEPH",
"name_suffix": "III",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-15",
"last_updated": "2023-10-20",
"certification_date": "2023-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "PA",
"license": "MD481135",
"primary": true
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "PA",
"license": "MT214398",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittston, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.