NPIMap

Individual provider Active NPI

Jamshid Khademi, MD

  • Anesthesiology Physician
  • Scranton, PA
National Provider Identifier
1831170869
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD064062L Issued in PA
Practice address
1800 Mulberry St.
Scranton, PA 18510-6800
Phone
(570) 703-8259
Fax
(570) 703-7250
NPI assigned
Nov 8, 2005
Last updated
Aug 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD064062L PA Primary

Addresses

Primary practice location

1800 Mulberry St.
Scranton, PA 18510-6800

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
01716353MedicaidPA
050083939OtherPARR MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jkhademi102700@direct.geisinger.edu Direct

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
I20100723000168 PA Practitioner - Anesthesiology 9537145180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1982
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)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD064062LPAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Nov 1, 2015 Accepting new patients
Geisinger Clinic CurrentSince Nov 1, 2015 Accepting new patients
Geisinger Clinic Anesthesiology Past Accepting new patients
Philadelphia Health & Education Corporation Past Accepting new patients

Locations

549 Fair St
Bloomsburg, PA 17815
Phone (570) 387-2100

16 Woodbine Ln
Danville, PA 17821
Phone (570) 271-6531

100 N Academy Ave
Danville, PA 17822

1020 Thompson St
Jersey Shore, PA 17740
Phone (570) 398-0100

400 Highland Ave
Lewistown, PA 17044
Phone (717) 242-7473

310 Electric Ave
Lewistown, PA 17044
Phone (717) 242-2531

1800 Mulberry St
Scranton, PA 18510
Phone (570) 703-7351

Interoperability endpoints

  • Direct secure messaging: jkhademi102700@direct.geisinger.edu

Organizations & group practices 5

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 10

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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1831170869",
    "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": "1800 MULBERRY ST.",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185106800",
            "telephone_number": "570-703-8259",
            "fax_number": "570-703-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHADEMI",
        "first_name": "JAMSHID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD064062L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01716353",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "050083939",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkhademi102700@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1800 Mulberry St.",
            "city": "Scranton",
            "state": "PA",
            "country_code": "US",
            "postal_code": "185106800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.