Individual provider Active NPI

Susan Leigh Mowatt, MD

  • Family Medicine Physician
  • Hawley, PA
National Provider Identifier
1699743450
Registry record updated Mar 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD071840L Issued in PA
Practice address
619 Church St
Hawley, PA 18428-1444
Phone
(570) 226-6077
Fax
(570) 561-2082
NPI assigned
Mar 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD071840L PA Primary

Addresses

Primary practice location

619 Church St
Hawley, PA 18428-1444

Mailing address

619 Church St
PO Box 635
Hawley, PA 18428-1444
Phone (570) 226-6077

Other identifiers 1

IdentifierTypeStateIssuer
0018206380008MedicaidPA

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
I20070108000191 PA Practitioner - Family Practice 8123028636 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD071840LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger-HM Joint Venture, LLC Family Medicine CurrentSince Dec 19, 2020 Accepting new patients
Geisinger Clinic Family Medicine CurrentSince Feb 15, 2021 Accepting new patients
Geisinger-HM Joint Venture, LLC Family Medicine Current Accepting new patients
Geisinger Clinic Family Medicine Current Accepting new patients
Geisinger Clinic CurrentSince Feb 15, 2021 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

1020 Thompson St
Jersey Shore, PA 17740
Phone (570) 398-0100

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268352000000",
    "number": "1699743450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 CHURCH ST",
            "address_2": "PO BOX 635",
            "city": "HAWLEY",
            "state": "PA",
            "postal_code": "184281444",
            "telephone_number": "570-226-6077",
            "fax_number": "570-561-2082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 CHURCH ST",
            "city": "HAWLEY",
            "state": "PA",
            "postal_code": "184281444",
            "telephone_number": "570-226-6077",
            "fax_number": "570-561-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOWATT",
        "first_name": "SUSAN",
        "middle_name": "LEIGH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2010-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD071840L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018206380008",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawley, PA

Sources for this page

Verify at the official NPI Registry.