Geisinger Clinic
Organization Active NPI Family Medicine Physician · Carbondale, PA
NPI 1700212917 · NPPES record last updated Feb 28, 2019
Key facts
- NPI
- 1700212917
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- GEISINGER CLINIC
- Practice address
- 267 Brooklyn St
Ste B
Carbondale, PA 18407-2836 - Phone
- (570) 282-4100
- Fax
- (570) 282-4200
- NPI assigned
- Sep 19, 2013
- Organization subpart
- No
Authorized official
- Name
- Cindy Mull
- Title
- Director
- Phone
- (570) 271-6144
Corporate family (same tax ID) 24
Practitioners 64
-
Rayhan Alam, MD
-
Joseph Charles Alario, D.O.
-
Justin M Azar, MD
-
Vanessa L Basara, CRNP
-
Jennifer Lyn Benesky, CRNA
-
James E Bland, MD
-
Cherish Marie Boehm, MSN, FNP-BC
-
Stephanie Lyn Bolger, PA-C
-
Anita Kim Buniak, DO
-
Mia Rose Casale, PA-C
-
Nil Celebi Cherukuri, MD, PHD
-
Rachel Charkaway, CRNP
-
Anne Sommerfeld Clause, PA-C
-
Malachi W Courtney, M.D.
-
Angela Delonti, CRNP
-
Diana Dawn Dutra, D.O.
-
Audrey K Eshleman, PA-C
-
Hannah Grant, DO
-
Mitchell J. Gross, M.D.
-
Daniel Guevin, PA-C
-
Matthew C Haley, DO
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040130000518 | PA | Part B Supplier - Clinic/Group Practice | 5395657001 |
Receives reassigned benefits from 5,323 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Geisinger Clinic Sunbury
Locations
240 Mall Blvd
Bloomsburg, PA 17815
Phone (570) 416-5435
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
267 Brooklyn St
Ste B
Carbondale, PA 18407-2836
Mailing address
100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-5555
Other providers in Carbondale, PA
- Corey Ann Frankowski
- Elese Frazier
- John J. Gallas
- Shirley A Gardner
- Geisinger Clinic
- Geisinger Clinic
- Ann Gerega
- Gina M Carlo DPM PC
- Donald A Gregory
- Lucrezia Grier
All providers in Carbondale, PA · Family Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.