Susan Lynn Kaczorowski, MD

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

MD044881E Issued in PA

Practice address

25 Church St
Wilkes Barre, PA 18702-3507

Phone

(570) 808-8831

Fax

(570) 808-8845

NPI assigned

Aug 2, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Clarks Summit, PA
  • NPI 1972910354
  NPD

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1689675431",
    "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": "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": "25 CHURCH ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187023507",
            "telephone_number": "570-808-8831",
            "fax_number": "570-808-8845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACZOROWSKI",
        "first_name": "SUSAN",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "PA",
            "license": "MD044881E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810000934",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2233827",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014069690003",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skaczorowski95847@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "25 Church St",
            "city": "Wilkes Barre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187023507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mary Ellen Judge, O.D.
• Justine Julien, MD
• Ernest Julius, MD
• Michael Thomas Jung
• Just Always Believe LLC
• Amy Elizabeth Kafrissen, LSW
• Matthew James Kahari, MD
• Nadine Kalavazoff, MD
• William P. Kalish, CRNA
• Joseph Daniel Kalowsky, D.O.

• Pediatric Critical Care Medicine Physician in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Pediatric Critical Care Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.