NPIMap

Individual provider Active NPI

Edward Joseph Walkowski Jr., MD

  • Diagnostic Radiology Physician
  • Peckville, PA
National Provider Identifier
1871543793
Registry record updated Nov 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD029668E Issued in PA
Practice address
1400 Main St
Peckville, PA 18452-2009
Phone
(570) 383-5671
NPI assigned
May 11, 2006
Last updated
Nov 29, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD029668E PA Primary

Addresses

Primary practice location

1400 Main St
Peckville, PA 18452-2009

Mailing address

RR 1 Box 434a
Dalton, PA 18414-9332
Phone (570) 383-5671

Other identifiers 1

IdentifierTypeStateIssuer
0011085910002MedicaidPA

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
I20071207000021 PA Practitioner - Diagnostic Radiology 0648369124 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scranton Hospitalist Physician Services LLCGroup PAC ID 7719163831, 46 clinicians

Practice addresses (Care Compare)

575 N River St
Wilkes Barre, PA 18702-2634
Phone (570) 770-3432

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.17 of 100Reported as apm
Quality
78.34
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD029668EPAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scranton Hospitalist Physician Services LLC Diagnostic Radiology CurrentSince May 28, 2025 Accepting new patients
Radiology Associates of Wyoming Valley, Inc Diagnostic Radiology CurrentSince Jan 1, 2016 Accepting new patients
Wilkes-Barre Clinic Company LLC Past Accepting new patients
Sheridan Radiology Services of West Florida, Inc. Diagnostic Radiology Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

239 S Mountain Blvd
Mountain Top, PA 18707
Phone (570) 715-7900

4 E Main St
Nanticoke, PA 18634
Phone (570) 258-3939

746 Jefferson Ave
Scranton, PA 18510
Phone (570) 340-5079

575 N River St
Wilkes Barre, PA 18764
Phone (570) 552-1300

575 N River St
Wilkes Barre Township, PA 18702
Phone (570) 283-3222

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511913600000",
    "number": "1871543793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 434A",
            "city": "DALTON",
            "state": "PA",
            "postal_code": "184149332",
            "telephone_number": "570-383-5671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MAIN ST",
            "city": "PECKVILLE",
            "state": "PA",
            "postal_code": "184522009",
            "telephone_number": "570-383-5671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKOWSKI",
        "first_name": "EDWARD",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2017-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD029668E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011085910002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peckville, PA

Sources for this page

Verify at the official NPI Registry.