Geisinger Clinic
Organization Active NPI Rheumatology Physician · Wilkes Barre, PA
NPI 1760434153 · NPPES record last updated Jun 30, 2008
Key facts
- NPI
- 1760434153
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rheumatology Physician 207RR0500X
- Legal business name
- GEISINGER CLINIC
- Practice address
- 1000 E Mountain Dr
Wilkes Barre, PA 18711 - Phone
- (570) 826-7300
- NPI assigned
- May 16, 2006
- Organization subpart
- No
Authorized official
- Name
- Kenneth Holdren
- Title
- Cao
- Phone
- (570) 271-5490
Corporate family (same tax ID) 24
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician |
207RR0500X | Yes |
Addresses
Primary practice location
1000 E Mountain Dr
Wilkes Barre, PA 18711
Mailing address
100 N Academy Ave
Danville, PA 17822-3034
Other providers in Wilkes Barre, PA
- Geisinger Clinic
- Geisinger Clinic
- Geisinger Clinic
- Geisinger Clinic
- Geisinger Clinic
- Geisinger Clinic
- Geisinger Clinic
- Geisinger Clinic
- Geisinger Clinic
- Geisinger Clinic
All providers in Wilkes Barre, PA · Rheumatology 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 Jun 30, 2008. 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.