NPIMap

Individual provider Active NPI

Stephanie Dosiak, PA-C

  • Physician Assistant
  • Wilkes Barre, PA
National Provider Identifier
1881143709
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA058595 Issued in PA
Practice address
1000 East Mountain Blvd.
Wilkes-Barre, PA 18711-3732
Phone
(570) 808-6026
NPI assigned
Oct 4, 2016
Last updated
Aug 31, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA058595 PA Primary
Medical Physician Assistant 363AM0700X MA058595 PA

Addresses

Primary practice location

1000 East Mountain Blvd.
Wilkes-Barre, PA 18711-3732

Mailing address

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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sdosiak139306@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
I20170308000987 PA Practitioner - Physician Assistant 7012291222 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

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

1000 E Mountain Dr
Wilkes Barre, PA 18711-0027
Phone (570) 826-7300

1155 E Mountain Blvd
Wilkes Barre, PA 18702-7906
Phone (570) 808-5135

1175 E Mountain Blvd
Suite 150723
Wilkes Barre, PA 18702-7906
Phone (570) 808-1093

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

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA058595PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Dec 27, 2016 Accepting new patients
Geisinger Clinic CurrentSince Dec 27, 2016 Accepting new patients
Caring Community Health Center CurrentSince Jan 13, 2020 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

426 Airport Rd
Ste 125
Hazle Township, PA 18202
Phone (570) 829-2621

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

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

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 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1881143709",
    "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": "1000 EAST MOUNTAIN BLVD.",
            "city": "WILKES-BARRE",
            "state": "PA",
            "postal_code": "187113732",
            "telephone_number": "570-808-6026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOSIAK",
        "first_name": "STEPHANIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA058595",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA058595",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdosiak139306@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1000 East Mountain Blvd.",
            "city": "Wilkes-Barre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187113732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.