Individual provider Active NPI

Michael C Raklewicz, MD

  • Orthopaedic Surgery Physician
  • Kingston, PA
National Provider Identifier
1770595027
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD014960E Issued in PA
Practice address
390 Pierce St
Kingston, PA 18704-5532
Phone
(570) 288-3535
Fax
(570) 288-0804
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD014960E PA Primary

Addresses

Primary practice location

390 Pierce St
Kingston, PA 18704-5532

Mailing address

PO Box 1463
Kingston, PA 18704-0463
Phone (570) 288-3535

Other identifiers 2

IdentifierTypeStateIssuer
0006104670005MedicaidPA
90067OtherPABLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address michael.raklewicz.1@21771.direct.athenahealth.com Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120112000100 PA Practitioner - Orthopedic Surgery 0244407427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Pittsburgh School of Medicine, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Physician Network LLCGroup PAC ID 2668696592, 63 clinicians

Practice addresses (Care Compare)

1099 S Township Blvd
Pittston, PA 18640-3247
Phone (570) 602-2400

390 Pierce St
Kingston, PA 18704-5532
Phone (570) 408-0410

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

Hospital & facility affiliations

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 Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Physician Network LLC CurrentSince Apr 1, 2019 Accepting new patients

Locations

390 Pierce St
Kingston, PA 18704
Phone (570) 288-3535

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

1099 S Township Blvd
Pittston, PA 18640
Phone (570) 602-2400

Organizations & group practices 1

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1770595027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1463",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187040463",
            "telephone_number": "570-288-3535",
            "fax_number": "570-288-0804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 PIERCE ST",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045532",
            "telephone_number": "570-288-3535",
            "fax_number": "570-288-0804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAKLEWICZ",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD014960E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006104670005",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "90067",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.raklewicz.1@21771.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "amr direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "390 Pierce St",
            "city": "Kingston",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187045532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kingston, PA

Sources for this page

Verify at the official NPI Registry.