Individual provider Active NPI

Jennifer Vodzak, M.D.

  • Pediatric Infectious Diseases Physician
  • Danville, PA
National Provider Identifier
1811152663
Registry record updated Aug 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
MD438505 Issued in PA
Practice address
100 North Academy Ave.
Danville, PA 17822-1339
Phone
(570) 271-6440
NPI assigned
Jul 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X 0439149 KS
Pediatrics Physician 208000000X MT189518 PA
Pediatric Infectious Diseases Physician 2080P0208X MD438505 PA Primary

Addresses

Primary practice location

100 North Academy Ave.
Danville, PA 17822-1339

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other practice location 1

5808 W 110th St
Overland Park, KS 66211-2504
Phone (816) 696-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jvodzak150257@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120925000265 PA Practitioner - Pediatric MedicinePractitioner - Infectious Disease 0840447314 Reassigns benefits to 1 organization
I20240104000552 DE Practitioner - Infectious Disease 0840447314 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT189518PAMDPediatrics Physician
0439149KSMDPediatric Infectious Diseases Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Sep 1, 2017 Accepting new patients
The Nemours Foundation CurrentSince Dec 1, 2023 Accepting new patients
The Nemours Foundation CurrentSince Dec 1, 2023 Accepting new patients
Geisinger Clinic CurrentSince Sep 1, 2017 Accepting new patients
Geisinger Clinic Current Accepting new patients
The Nemours Foundation Past Accepting new patients

Locations

1600 Rockland Rd
Wilmington, DE 19803

100 N Academy Ave
Danville, PA 17822

Interoperability endpoints

  • Direct secure messaging: jvodzak150257@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.

NPI Registry JSON

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598745600000",
    "number": "1811152663",
    "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": "100 NORTH ACADEMY AVE.",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178221339",
            "telephone_number": "570-271-6440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5808 W 110th St",
            "address_purpose": "LOCATION",
            "city": "Overland Park",
            "state": "KS",
            "postal_code": "662112504",
            "country_code": "US",
            "telephone_number": "816-696-8000",
            "fax_number": "816-302-9939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VODZAK",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-22",
        "last_updated": "2020-08-30",
        "certification_date": "2020-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "KS",
            "license": "0439149",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT189518",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "PA",
            "license": "MD438505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jvodzak150257@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 North Academy Ave.",
            "city": "Danville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178221339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.