Individual provider Active NPI

Barry J Pernikoff, M.D.

  • Colon & Rectal Surgery Physician
  • Plains, PA
National Provider Identifier
1609844646
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
MD044775L Issued in PA
Practice address
200 S River St
Plains, PA 18705-1143
Phone
(570) 821-1100
Fax
(570) 821-1108
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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 MD044775L PA
Colon & Rectal Surgery Physician 208C00000X MD044775L PA Primary

Addresses

Primary practice location

200 S River St
Plains, PA 18705-1143

Mailing address

200 S River St
Plains, PA 18705-1143
Phone (570) 821-1100

Other identifiers 1

IdentifierTypeStateIssuer
1249713010MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address barry.pernikoff.1@21771.direct.athenahealth.com

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
I20110523000149 PA Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 5799961074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
Pennsylvania State University College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Physician Network LLCGroup PAC ID 2668696592, 63 clinicians

Practice addresses (Care Compare)

200 S River St
Plains, PA 18705-1143
Phone (570) 821-1100

4 E Main St
Nanticoke, PA 18634-1602
Phone (570) 735-7474

575 N River St
Wilkes Barre, PA 18702-2634
Phone (570) 552-8938

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.17 of 100Reported as apm
Quality
78.34
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy76
Hernia repair - groin (open)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Physician Network LLC Surgery CurrentSince Apr 1, 2018 Accepting new patients
Wilkes Barre Hospital Company LLC Past Accepting new patients

Locations

4 E Main St
Nanticoke, PA 18634
Phone (570) 258-3939

200 S River St
Plains, PA 18705
Phone (570) 821-1100

Interoperability endpoints

  • Direct secure messaging: barry.pernikoff.1@21771.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1609844646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S RIVER ST",
            "city": "PLAINS",
            "state": "PA",
            "postal_code": "187051143",
            "telephone_number": "570-821-1100",
            "fax_number": "570-821-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S RIVER ST",
            "city": "PLAINS",
            "state": "PA",
            "postal_code": "187051143",
            "telephone_number": "570-821-1100",
            "fax_number": "570-821-1108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERNIKOFF",
        "first_name": "BARRY",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD044775L",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "PA",
            "license": "MD044775L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1249713010",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "barry.pernikoff.1@21771.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "200 S River St",
            "city": "Plains",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187051143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plains, PA

Sources for this page

Verify at the official NPI Registry.