NPIMap

Individual provider Active NPI

Scott L Blakiewicz, PA-C

  • Physician Assistant
  • Scranton, PA
National Provider Identifier
1790419968
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA063600 Issued in PA
Practice address
3 W Olive St
Scranton, PA 18508-2572
Phone
(800) 275-6401
Fax
(570) 558-2101
NPI assigned
Jul 13, 2022
Last updated
Oct 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA063600 PA Primary

Addresses

Primary practice location

3 W Olive St
Scranton, PA 18508-2572

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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221102002578 PA Practitioner - Physician Assistant 4789724998 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

1800 Mulberry St
Scranton, PA 18510-2369
Phone (570) 969-7355

3 W Olive St
Scranton, PA 18508-2572
Phone (570) 207-5970

950 E Mountain Blvd
Wilkes Barre, PA 18702-7924
Phone (570) 808-5770

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Physician Assistant CurrentSince Oct 17, 2022 Accepting new patients
Wayne Memorial Hospital CurrentSince Apr 6, 2024 Accepting new patients
Geisinger Clinic CurrentSince Oct 17, 2022 Accepting new patients
Wayne Memorial Hospital CurrentSince Apr 6, 2024 Accepting new patients
Geisinger Clinic GYN Onc Physician Assistant Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

601 Park St
Honesdale, PA 18431
Phone (570) 253-8100

3 W Olive St
Scranton, PA 18508
Phone (570) 207-4054

Interoperability endpoints

  • Direct secure messaging: sblakiewicz508843@direct.geisinger.edu

Organizations & group practices 6

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.

Hospital & facility affiliations 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1790419968",
    "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": "3 W OLIVE ST",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185082572",
            "telephone_number": "800-275-6401",
            "fax_number": "570-558-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKIEWICZ",
        "first_name": "SCOTT",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-13",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA063600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.