NPIMap

Individual provider Active NPI

Michael L Kondash, DO

  • Family Medicine Physician
  • South Abington Township, PA
National Provider Identifier
1710966536
Registry record updated Aug 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS006653L Issued in PA
Practice address
790 Northern Blvd
Suite K
South Abington Township, PA 18411-8799
Phone
(570) 586-4141
Fax
(570) 586-6722
NPI assigned
Jan 11, 2006
Last updated
Aug 6, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 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 OS006653L PA Primary

Addresses

Primary practice location

790 Northern Blvd
Suite K
South Abington Township, PA 18411-8799

Mailing address

790 Northern Blvd
Suite K
South Abington Township, PA 18411-8799
Phone (570) 586-4141

Other identifiers 1

IdentifierTypeStateIssuer
001440094MedicaidPA

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
I20100719000478 PA Practitioner - Family PracticePractitioner - Geriatric Medicine 3870676364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Philadelphia College of Osteopathic Medicine, 1986
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)

531 Mt Pleasant Dr
Scranton, PA 18503-1987
Phone (570) 342-8500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS006653LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Oct 1, 2014 Accepting new patients
Geisinger Clinic Family Medicine Current Accepting new patients
Geisinger Clinic CurrentSince Oct 1, 2014 Accepting new patients
Geisinger Clinic Past Accepting new patients
Lackawanna Healthcare Associates LLC Past Accepting new patients
Pennsylvania LTC Inc Past Accepting new patients
Riverside Rehabilitation and Healthcare LLC Past Accepting new patients
Abington Manor Opco LLC Past Accepting new patients
Allied Services Skilled Nursing Center Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

407 3rd Ave
Jessup, PA 18434
Phone (570) 383-7922

125 Scranton Pocono Hwy
Scranton, PA 18505
Phone (570) 342-8500

435 Scranton Carbondale Hwy
Scranton, PA 18508
Phone (570) 343-4334

531 Mt Pleasant Dr
Scranton, PA 18503
Phone (570) 342-8500

Interoperability endpoints

  • Direct secure messaging: mkondash@primemed.medentdirect.com

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Tunkhannock Rehabilitation & Health Care CenterTunkhannock, PA, CCN 396151 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2025
Mar 1, 2025

Owned or controlled facilities with NPI records 1

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

Organizations & group practices 9

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 72

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

View all 72

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281052800000",
    "number": "1710966536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 NORTHERN BLVD",
            "address_2": "SUITE K",
            "city": "SOUTH ABINGTON TOWNSHIP",
            "state": "PA",
            "postal_code": "184118799",
            "telephone_number": "570-586-4141",
            "fax_number": "570-586-6722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 NORTHERN BLVD",
            "address_2": "SUITE K",
            "city": "SOUTH ABINGTON TOWNSHIP",
            "state": "PA",
            "postal_code": "184118799",
            "telephone_number": "570-586-4141",
            "fax_number": "570-586-6722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDASH",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2010-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS006653L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001440094",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Abington Township, PA

Sources for this page

Verify at the official NPI Registry.