NPIMap

Individual provider Active NPI

Nicholas David Dodge, MD

  • Internal Medicine Physician
  • Dunmore, PA
National Provider Identifier
1679534226
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD054271L Issued in PA
Practice address
414 E Drinker St Ste 204
Dunmore, PA 18512-2469
Phone
(570) 344-5115
Fax
(570) 344-2123
NPI assigned
Mar 31, 2006
Last updated
Apr 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD054271L PA Primary

Addresses

Primary practice location

414 E Drinker St Ste 204
Dunmore, PA 18512-2469

Mailing address

100 N Academy Ave # Mc4903
Danville, PA 17822-9800
Phone (570) 271-6144

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ndodge101991@direct.geisinger.edu Direct

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
I20100909000997 PA Practitioner - Internal Medicine 4587789888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Temple University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

414 E Drinker St
Dunmore, PA 18512-2469
Phone (570) 344-5115

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD054271LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Feb 24, 2025 Accepting new patients
Nicholas Dodge, M.D., P.C. Internal Medicine CurrentSince May 28, 2003 Accepting new patients
Geisinger Clinic CurrentSince Feb 24, 2025 Accepting new patients
Scranton Healthcare Group, Inc. Past Accepting new patients
Mid-Valley SNF Healthcare, LLC Past Accepting new patients
Green Ridge Healthcare Group, LLC Past Accepting new patients
Allied Healthcare Services Past Accepting new patients
Geisinger Bloomsburg Hospital Past Accepting new patients
Allied Healthcare Services Past Accepting new patients
Dunmore Healthcare Group, Inc. Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

100 N Academy Ave
#4903
Danville, PA 17822

414 E Drinker St
Ste 204
Dunmore, PA 18512
Phone (570) 344-5115

57 N Main St
Pittston, PA 18640
Phone (570) 602-5620

1401 Electric St
Scranton, PA 18509
Phone (570) 770-5929

Interoperability endpoints

  • Direct secure messaging: ndodge101991@direct.geisinger.edu

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Scranton Health Care CenterScranton, PA, CCN 396095 Skilled nursing facility Corporate Director Oct 1, 2007
Mid-Valley Health Care CenterPeckville, PA, CCN 395644 Skilled nursing facility Adp of the SNF Jan 18, 2016
Residential Healthcare of NE PA LLCMoosic, PA, CCN 391572 Hospice Contracted Managing Employee Jan 14, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 11

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 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1679534226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE # MC4903",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178229800",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 E DRINKER ST STE 204",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185122469",
            "telephone_number": "570-344-5115",
            "fax_number": "570-344-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODGE",
        "first_name": "NICHOLAS",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD054271L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ndodge101991@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "414 E Drinker St Ste 204",
            "city": "Dunmore",
            "state": "PA",
            "country_code": "US",
            "postal_code": "185122469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dunmore, PA

Sources for this page

Verify at the official NPI Registry.