NPIMap

Individual provider Active NPI

Denise Marie Klynowsky-Farrell, DO

  • Family Medicine Physician
  • Hanover Township, PA
National Provider Identifier
1730169079
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS009866L Issued in PA
Practice address
111 W End Rd Ste 101
Hanover Township, PA 18706-5448
Phone
(570) 208-4035
Fax
(570) 208-4038
NPI assigned
Jan 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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 OS009866L PA Primary

Addresses

Primary practice location

111 W End Rd Ste 101
Hanover Township, PA 18706-5448

Mailing address

111 W End Rd Ste 101
Hanover Township, PA 18706-5448
Phone (570) 208-4035

Other practice location 1

96 Wood St
Wilkes Barre, PA 18702-3612
Phone (570) 829-0503

Other identifiers 1

IdentifierTypeStateIssuer
0017038740009MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address denise.klynowsky-farrell.1@21771.direct.athenahealth.com

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
I20050627000465 PA Practitioner - Family Practice 5193760593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Commonwealth Physician Network LLCGroup PAC ID 2668696592, 63 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, 2,775 clinicians

Practice addresses (Care Compare)

111 W End Rd
Suite 101
Hanover TWP, PA 18706-5448
Phone (570) 819-2825

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

4 E Main St
Nanticoke, PA 18634-1602
Phone (570) 735-7474

Hospital & facility affiliations

  • Associated Family Home Care, Inc. Home health agency, Kingston, PA, CCN 397502
  • Wilkes-Barre General Hospital Hospital, Wilkes-Barre, PA, CCN 390137
  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270
  • John Heinz Institute of Rehabilitation Medicine Inpatient rehabilitation facility, Wilkes Barre Townshi, PA, CCN 393036

Merit-based Incentive Payment System (MIPS)

Final score
89.17 of 100Reported as apm
Quality
78.34
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS009866LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Physician Network LLC Family Medicine CurrentSince Nov 15, 2023 Accepting new patients

Locations

111 W End Rd
Ste 101
Hanover Township, PA 18706
Phone (570) 208-4035

610 Wyoming Ave
#2
Kingston, PA 18704
Phone (570) 714-1032

610 Wyoming Ave
Kingston, PA 18704
Phone (570) 288-5441

4 E Main St
Nanticoke, PA 18634
Phone (570) 258-3939

575 N River St
Wilkes Barre, PA 18764
Phone (570) 552-1300

575 N River St
Wilkes Barre Township, PA 18702
Phone (570) 283-3222

Organizations & group practices 3

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.

Hospital & facility affiliations 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1730169079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W END RD STE 101",
            "city": "HANOVER TOWNSHIP",
            "state": "PA",
            "postal_code": "187065448",
            "telephone_number": "570-208-4035",
            "fax_number": "570-208-4038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W END RD STE 101",
            "city": "HANOVER TOWNSHIP",
            "state": "PA",
            "postal_code": "187065448",
            "telephone_number": "570-208-4035",
            "fax_number": "570-208-4038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "96 Wood St",
            "address_purpose": "LOCATION",
            "city": "Wilkes Barre",
            "state": "PA",
            "postal_code": "187023612",
            "country_code": "US",
            "telephone_number": "570-829-0503",
            "fax_number": "570-829-6267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLYNOWSKY-FARRELL",
        "first_name": "DENISE",
        "middle_name": "MARIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-20",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS009866L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017038740009",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "denise.klynowsky-farrell.1@21771.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "amr direct address",
            "address_1": "111 W End Rd Ste 101",
            "city": "Hanover Township",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187065448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hanover Township, PA

Sources for this page

Verify at the official NPI Registry.