Individual provider Active NPI

Chris A Patestos, MD

  • Pediatrics Physician
  • Mountain Top, PA
National Provider Identifier
1780672832
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD492956 Issued in PA
Practice address
35 S Mountain Blvd
Mountain Top, PA 18707-1122
Phone
(570) 474-5072
Fax
(570) 474-6941
NPI assigned
Oct 12, 2005
Last updated
Mar 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD492956 PA Primary

Addresses

Primary practice location

35 S Mountain Blvd
Mountain Top, PA 18707-1122

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 474-5072

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
I20260129000306 PA Practitioner - Pediatric Medicine 5597243832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD492956PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Mar 16, 2026 Accepting new patients
Geisinger Clinic CurrentSince Mar 16, 2026 Accepting new patients
Geisinger Clinic Pediatrics Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

35 S Mountain Blvd
Wilkes Barre, PA 18707
Phone (570) 474-5072

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1780672832",
    "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": "570-474-5072",
            "fax_number": "570-474-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 S MOUNTAIN BLVD",
            "city": "MOUNTAIN TOP",
            "state": "PA",
            "postal_code": "187071122",
            "telephone_number": "570-474-5072",
            "fax_number": "570-474-6941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATESTOS",
        "first_name": "CHRIS",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD492956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Top, PA

Sources for this page

Verify at the official NPI Registry.