NPIMap

Individual provider Active NPI

Roman W Matlaga, DO

  • Internal Medicine Physician
  • Wilkes Barre, PA
National Provider Identifier
1881688315
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS008779L Issued in PA
Practice address
660 Baltimore Dr
Wilkes Barre, PA 18702-7962
Phone
(570) 808-6444
NPI assigned
Sep 12, 2005
Last updated
Apr 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS008779L PA
Internal Medicine Physician 207R00000X OS008779L PA Primary

Addresses

Primary practice location

660 Baltimore Dr
Wilkes Barre, PA 18702-7962

Mailing address

100 N Academy Ave # Mc4903
Danville, PA 17822-9800
Phone (570) 271-6144

Other practice location 1

103 Spruce St
Hawley, PA 18428-1149
Phone (570) 390-4545

Other practice location 2

300 Lackawanna Ave Ste 200
Scranton, PA 18503-2001
Phone (570) 800-7515

Other identifiers 3

IdentifierTypeStateIssuer
785660OtherPABLUE SHIELD
814113OtherPAFIRST PRIORITY HEALTH
001539491MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rmatlaga61925@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
I20060626000233 PA Practitioner - Internal MedicinePractitioner - Emergency Medicine 9638181167 Reassigns benefits to 4 organizations
Practice locations: Waymart, PA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

660 Baltimore Dr
Wilkes Barre, PA 18702-7962
Phone (570) 808-6444

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS008779LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Schuylkill Health System Medical Group, Inc. Emergency Medicine CurrentSince Dec 11, 2023 Accepting new patients
Lehigh Valley Physician Group CurrentSince Oct 17, 2022 Accepting new patients
Family Care Centers Inc Emergency Medicine CurrentSince Dec 11, 2023 Accepting new patients
Geisinger Clinic Current Accepting new patients
Lehigh Valley Physician Group Emergency Medicine Current Accepting new patients
Geisinger Clinic CurrentSince Jan 20, 2025 Accepting new patients
Schuylkill Health System Medical Group, Inc. Internal Medicine CurrentSince Dec 11, 2023 Accepting new patients
Family Care Centers Inc. Internal Medicine Current Accepting new patients
Lehigh Valley Physician Group Emergency Medicine CurrentSince Oct 17, 2022 Accepting new patients
Geisinger Clinic CurrentSince Jan 20, 2025 Accepting new patients
Northwest New Jersey Urgent Care Alliance PC Past Accepting new patients
Northeastern Rehabilitation Associates, PC Past Accepting new patients
Wayne Woodlands Manor Past Accepting new patients
Hogarth Emergency Physicians Emergency Medicine Past Accepting new patients
Professional Emergency Care, PC Emergency Medicine Past Accepting new patients

Locations

267 Brooklyn St
Ste B
Carbondale, PA 18407
Phone (570) 282-4100

100 N Academy Ave
Danville, PA 17822

100 N Academy Ave
#4903
Danville, PA 17822

500 Plaza Ct
East Stroudsburg, PA 18301
Phone (570) 426-2330

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

300 Lackawanna Ave
Ste 200
Scranton, PA 18503
Phone (570) 342-7864

660 Baltimore Dr
Wilkes Barre, PA 18702
Phone (570) 808-6444

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1881688315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE # MC4903",
            "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": "660 BALTIMORE DR",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187027962",
            "telephone_number": "570-808-6444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Spruce St",
            "address_purpose": "LOCATION",
            "city": "Hawley",
            "state": "PA",
            "postal_code": "184281149",
            "country_code": "US",
            "telephone_number": "570-390-4545",
            "fax_number": "570-390-4546",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Lackawanna Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Scranton",
            "state": "PA",
            "postal_code": "185032001",
            "country_code": "US",
            "telephone_number": "570-800-7515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATLAGA",
        "first_name": "ROMAN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS008779L",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS008779L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "785660",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH",
            "identifier": "814113",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001539491",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmatlaga61925@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "660 Baltimore Dr",
            "city": "Wilkes Barre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187027962",
            "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.