NPIMap

Organization Active NPI

Geisinger Clinic Sunbury

  • Internal Medicine Physician
  • Sunbury, PA
National Provider Identifier
1740239243
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GEISINGER CLINIC SUNBURY
Practice address
385 State St
Sunbury, PA 17801
Phone
(570) 286-3934
NPI assigned
May 10, 2006
Last updated
Jun 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Authorized official

Name
Cindy L Mull
Title
System Director Enrollments
Phone
(570) 271-6603

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X PA
Durable Medical Equipment & Medical Supplies 332B00000X
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X Primary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X
Pediatrics Physician 208000000X

Addresses

Primary practice location

385 State St
Sunbury, PA 17801

Mailing address

100 N Academy Ave
Danville, PA 17822-3034

Other practice location 1

1151 N. 4th Street
Sunbury, PA 17801-1221
Phone (570) 286-6773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0189121Geisinger Sunbury1151 North 4TH Street, Sunbury, PA 17801Certificate of waiverJun 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
Geisinger Cancer Center of Lewisburg275 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

224 N Logan Blvd
Ste 220
Burnham, PA 17009
Phone (717) 242-0196

1211 Forge Rd
Carlisle, PA 17013
Phone (717) 218-3920

100 N Academy Ave
Ste 4310
Danville, PA 17822

1000 E Mtn Dr
Danville, PA 17822
Phone (570) 271-6361

1151 N 4th St
Sunbury, PA 17801
Phone (570) 286-6773

10 Trieble Dr
Ste 3
Tunkhannock, PA 18657
Phone (570) 836-2020

439 N West St
York, PA 17404
Phone (717) 848-2947

Practitioners & affiliated clinicians

Practitioners 82

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 82

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624924800000",
    "number": "1740239243",
    "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": "178223034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 STATE ST",
            "city": "SUNBURY",
            "state": "PA",
            "postal_code": "17801",
            "telephone_number": "570-286-3934"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1151 N. 4th Street",
            "address_purpose": "LOCATION",
            "city": "Sunbury",
            "state": "PA",
            "postal_code": "178011221",
            "country_code": "US",
            "telephone_number": "570-286-6773",
            "fax_number": "570-286-7967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GEISINGER CLINIC SUNBURY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-09",
        "status": "A",
        "authorized_official_last_name": "MULL",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR ENROLLMENTS",
        "authorized_official_telephone_number": "570-271-6603"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunbury, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.