NPIMap

Individual provider Active NPI

Matthew Alan Facktor, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Danville, PA
National Provider Identifier
1891747895
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MD429109 Issued in PA
Practice address
100 N Academy Ave
Department of Thoracic Surgery
Danville, PA 17822-2150
Phone
(570) 271-6367
Fax
(570) 271-5840
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD429109 PA Primary

Addresses

Primary practice location

100 N Academy Ave
Department of Thoracic Surgery
Danville, PA 17822-2150

Mailing address

100 N Academy Ave
Department of Thoracic Surgery
Danville, PA 17822-2150
Phone (570) 271-6367

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mfacktor84095@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
I20060810000247 PA Practitioner - Thoracic SurgeryPractitioner - General Surgery 8628069051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: General Surgery
Education
Wayne State University School of Medicine, 1996
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)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6211

Hospital & facility affiliations

  • Geisinger Medical Center Hospital, Danville, PA, CCN 390006
  • Geisinger-Lewistown Hospital Hospital, Lewistown, PA, CCN 390048
  • Geisinger-Bloomsburg Hospital Hospital, Bloomsburg, PA, CCN 390003
  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270
  • Geisinger Jersey Shore Hospital Hospital, Jersey Shore, PA, CCN 391300

Procedures performed for Medicare patients

ProcedureNumber of procedures
Laminectomy or laminotomy (partial removal of spine bones)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD429109PAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Aug 1, 2006 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Aug 1, 2006 Accepting new patients
Medical Faculty Associates, Inc Past Accepting new patients
Geisinger Clinic Past Accepting new patients
Geisinger Medical Center Past Accepting new patients
Washington Cardiothoracic Surgery Assoc.,PLLC Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

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

Interoperability endpoints

  • Direct secure messaging: mfacktor84095@direct.geisinger.edu

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 59

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

View all 59

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1891747895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "address_2": "DEPARTMENT OF THORACIC SURGERY",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178222150",
            "telephone_number": "570-271-6367",
            "fax_number": "570-271-5840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "address_2": "DEPARTMENT OF THORACIC SURGERY",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178222150",
            "telephone_number": "570-271-6367",
            "fax_number": "570-271-5840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FACKTOR",
        "first_name": "MATTHEW",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PA",
            "license": "MD429109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfacktor84095@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 N Academy Ave",
            "address_2": "Department of Thoracic Surgery",
            "city": "Danville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178222150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.