Active NPI
Tyler C Woodruff, PA-C
- Physician Assistant
- Scranton, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA063824
- Practice address
- 1800 Mulberry St
Scranton, PA 18510-2369 - Phone
- (570) 703-8000
- Fax
- (570) 703-8512
- NPI assigned
- Sep 12, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA063824 | PA | Primary |
Addresses
Primary practice location
1800 Mulberry St
Scranton, PA 18510-2369
Mailing address
100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Phoenix Rehabilitation and Health Services Inc
Practice addresses (Care Compare)
100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144
1000 E Mountain Dr
Wilkes Barre, PA 18711-0027
Phone (570) 826-7300
1155 E Mountain Blvd
Wilkes Barre, PA 18702-7906
Phone (570) 808-5135
1175 E Mountain Blvd
Suite 150723
Wilkes Barre, PA 18702-7906
Phone (570) 808-1093
2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238
300 Lackawanna Ave
Scranton, PA 18503-2001
Phone (570) 961-3823
Hospital & facility affiliations
- Geisinger Wyoming Valley Medical Center
- John Heinz Institute of Rehabilitation Medicine
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA063824 | PA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Geisinger Clinic | Current | Accepting new patients | |
| Geisinger Clinic | Physician Assistant | Current | Accepting new patients |
| Geisinger Clinic | Past | Accepting new patients |
Locations
100 N Academy Ave
Danville, PA 17822
3 W Olive St
Scranton, PA 18508
Phone (570) 207-4054
1800 Mulberry St
Scranton, PA 18510
Phone (570) 703-7351
1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300
Interoperability endpoints
- twoodruff541738@direct.geisinger.edu
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Danville, PA
- NPI 1366493868
-
- Diagnostic Radiology Physician
- Danville, PA
- NPI 1558313023
-
- Hospitalist Physician
- Wilkes Barre, PA
- NPI 1588614358
Hospital & facility affiliations 21
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Diagnostic Radiology Physician
- Pittston, PA
- NPI 1104292960
Hospital
-
- General Acute Care Hospital
- Wilkes Barre, PA
- NPI 1174822068
-
- General Acute Care Hospital
- Wilkes Barre, PA
- NPI 1275620585
-
- General Acute Care Hospital
- Pittston, PA
- NPI 1316692585
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667952000000",
"number": "1760104343",
"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": "178224903",
"telephone_number": "570-271-6144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 MULBERRY ST",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185102369",
"telephone_number": "570-703-8000",
"fax_number": "570-703-8512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODRUFF",
"first_name": "TYLER",
"middle_name": "C",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-12",
"last_updated": "2022-11-09",
"certification_date": "2022-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA063824",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scranton, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.