Individual provider Active NPI

Kyle Peter Woolfolk, PA-C

  • Physician Assistant
  • Scranton, PA
National Provider Identifier
1922478353
Registry record updated Aug 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
OA003628 Issued in PA
Practice address
531 Mt Pleasant Dr
Scranton, PA 18503-1987
Phone
(570) 342-8500
Fax
(570) 558-2290
NPI assigned
Sep 28, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X OA003628 PA
Physician Assistant 363A00000X OA003628 PA Primary

Addresses

Primary practice location

531 Mt Pleasant Dr
Scranton, PA 18503-1987

Mailing address

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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kwoolfolk130223@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160204000873 PA Practitioner - Physician Assistant 1850695214 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Nov 4, 2019 Accepting new patients
Geisinger Clinic CurrentSince Nov 4, 2019 Accepting new patients
Geisinger Clinic Physician Assistant Current Accepting new patients
Geisinger Clinic Past Accepting new patients
Caring Community Health Center Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

4004 Birney Ave
Moosic, PA 18507
Phone (570) 344-4711

12 Kirby Ave
Mountain Top, PA 18707
Phone (570) 474-5978

57 N Main St
Pittston, PA 18640
Phone (570) 602-5620

125 Scranton Pocono Hwy
Scranton, PA 18505
Phone (570) 342-8500

531 Mt Pleasant Dr
Scranton, PA 18503
Phone (570) 342-8500

Interoperability endpoints

  • Direct secure messaging: kwoolfolk130223@direct.geisinger.edu

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598745600000",
    "number": "1922478353",
    "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": "531 MT PLEASANT DR",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185031987",
            "telephone_number": "570-342-8500",
            "fax_number": "570-558-2290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLFOLK",
        "first_name": "KYLE",
        "middle_name": "PETER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-28",
        "last_updated": "2020-08-30",
        "certification_date": "2020-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "OA003628",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA003628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwoolfolk130223@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "531 Mt Pleasant Dr",
            "city": "Scranton",
            "state": "PA",
            "country_code": "US",
            "postal_code": "185031987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.