Individual provider Active NPI

Maria Clavell

  • Pediatric Gastroenterology Physician
  • Kingston, PA
National Provider Identifier
1811969595
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
MD070713L Issued in PA
Practice address
190 Welles St
Kingston, PA 18704-4968
Phone
(570) 718-4140
Fax
(570) 718-4141
NPI assigned
Feb 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD070713L PA
Pediatric Gastroenterology Physician 2080P0206X MD070713L PA Primary

Addresses

Primary practice location

190 Welles St
Kingston, PA 18704-4968

Mailing address

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

Other practice location 1

3705 5th Ave
Room 3200DW
Pittsburgh, PA 15213-2584
Phone (412) 692-5180

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address upmchospitals@upmcdirect.com UPMC

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
I20081216000461 PA Practitioner - Pediatric MedicinePractitioner - Gastroenterology 1456413087 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD070713LPAMDPediatric Gastroenterology Physician
20448SCMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians CurrentSince May 24, 2000 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic Pediatric Gastroenterology CurrentSince Mar 18, 2024 Accepting new patients
University of Pittsburgh Physicians CurrentSince May 24, 2000 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
Geisinger Clinic CurrentSince Mar 18, 2024 Accepting new patients
Geisinger Clinic Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

190 Welles St
Kingston, PA 18704
Phone (570) 283-0524

190 Welles St
Ste 122
Kingston, PA 18704
Phone (570) 718-4140

3705 Desoto St
Pittsburgh, PA 15213
Phone (412) 692-5260

1201 Oak St
Pittston, PA 18640
Phone (570) 808-9800

519 Penn Ave
Ste 206
Turtle Creek, PA 15145
Phone (412) 823-3121

1000 E Mountain Blvd
Wilkes Barre, PA 18711
Phone (570) 808-7399

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1811969595",
    "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": "178229800",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 WELLES ST",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187044968",
            "telephone_number": "570-718-4140",
            "fax_number": "570-718-4141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3705 5th Ave",
            "address_2": "ROOM 3200DW",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152132584",
            "country_code": "US",
            "telephone_number": "412-692-5180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLAVELL",
        "first_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-06",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD070713L",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "PA",
            "license": "MD070713L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "upmchospitals@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kingston, PA

Sources for this page

Verify at the official NPI Registry.