Pediatric Practices of Northeastern PA

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

PEDIATRIC PRACTICES OF NORTHEASTERN PA

Practice address

27B Woodlands Dr
Waymart, PA 18472-9366

Phone

(570) 448-9550

Fax

(570) 488-9553

NPI assigned

Feb 2, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Robert Morton, MD

Title

Partner

Phone

(570) 253-5838

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Pediatric Practices of Northeastern PA Other name

Tax ID family

Pediatric Practices of Northeastern PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Pediatric Practices of Northeastern PA

  • Pediatrics Physician
  • Milford, PA
  • NPI 1861722902
  NPD tax ID

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

{
    "created_epoch": "1265068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563840000000",
    "number": "1578895538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1837 FAIR AVE",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184312121",
            "telephone_number": "570-488-9550",
            "fax_number": "570-488-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27B WOODLANDS DR",
            "city": "WAYMART",
            "state": "PA",
            "postal_code": "184729366",
            "telephone_number": "570-448-9550",
            "fax_number": "570-488-9553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1837 Fair Ave",
            "address_purpose": "LOCATION",
            "city": "Honesdale",
            "state": "PA",
            "postal_code": "184312121",
            "country_code": "US",
            "telephone_number": "570-253-5838 x124",
            "fax_number": "570-253-6678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PEDIATRIC PRACTICES OF NORTHEASTERN PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-02",
        "last_updated": "2019-07-23",
        "status": "A",
        "authorized_official_last_name": "MORTON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "570-253-5838",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS CERTIFICATION NUMBER",
            "identifier": "39-3906",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007422260018",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Practices of Northeastern PA",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Pediatric Practices of Northeastern PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Maxis Medical Services
• Mogerman Jason Orthopaedic Institute,LLC
• Jeffrey A Mogerman, MD
• Allen J Orehek, MD
• Katherine Orehek
• Kenneth A Phillips, OD
• Joseph Quinones
• Cathy Marie Salak, DMD
• Mollie Schubert, M.S. CCC-SLP
• Colleen C Siepiela-Carmody

• Rural Health Clinic/Center in Waymart, PA
• Providers in Waymart, PA by specialty
• Rural Health Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.