NPIMap

Organization Active NPI

Geisinger Clinic

  • Cardiac Rehabilitation Registered Nurse
  • Wilkes Barre, PA
National Provider Identifier
1841995214
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiac Rehabilitation Registered NurseTaxonomy code 163WC3500X
Legal business name
GEISINGER CLINIC
Practice address
675 Baltimore Dr
Wilkes Barre, PA 18702-7900
Phone
(570) 808-7973
Fax
(570) 808-5383
NPI assigned
Apr 4, 2023
Last updated
Apr 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Authorized official

Name
Cindy L Mull
Title
System Director Credentialing
Phone
(570) 271-6603

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiac Rehabilitation Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WC3500X Primary

Addresses

Primary practice location

675 Baltimore Dr
Wilkes Barre, PA 18702-7900

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230605003370 PA Part B Supplier - Intensive Cardiac Rehabilitation 5395657001 Receives reassigned benefits from 4 practitioners
Practice locations: Wilkes Barre, PA

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Geisinger Medical Oncology Lock Haven275 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Geisinger Home HealthDanville, PA, CCN 397718 Home health agency 5% Or Greater Indirect Ownership Interest (25%) Apr 1, 2019
Geisinger Home HealthHazle Township, PA, CCN 398030 Home health agency 5% Or Greater Indirect Ownership Interest (25%) Apr 1, 2019
Geisinger HospiceDanville, PA, CCN 391533 Hospice 5% Or Greater Indirect Ownership Interest (25%) Apr 1, 2019

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • LHCG CXL, LLC

    dba Geisinger Hospice

    • Community Based Hospice Care Agency
    • Danville, PA
    • NPI 1972060226

    5% Or Greater Indirect Ownership Interest

    CMS ownership
  • LHCG Cxli, LLC

    dba Geisinger Home Health

    • Home Health Agency
    • Danville, PA
    • NPI 1740747088

    5% Or Greater Indirect Ownership Interest

    CMS ownership
  • LHCG Cxliii, LLC

    dba Geisinger Home Health

    • Home Health Agency
    • Hazle Township, PA
    • NPI 1245797570

    5% Or Greater Indirect Ownership Interest

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681344000000",
    "number": "1841995214",
    "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",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 BALTIMORE DR",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187027900",
            "telephone_number": "570-808-7973",
            "fax_number": "570-808-5383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEISINGER CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-04",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A",
        "authorized_official_last_name": "MULL",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR CREDENTIALING",
        "authorized_official_telephone_number": "570-271-6603"
    },
    "taxonomies": [
        {
            "code": "163WC3500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Cardiac Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.