NPIMap

Individual provider Active NPI

Mario L. Adajar Jr., M.D.

  • Internal Medicine Physician
  • Wilkes Barre, PA
National Provider Identifier
1962476267
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD069294L Issued in PA
Practice address
25 Church St
Wilkes Barre, PA 18765-0999
Phone
(570) 826-3100
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD069294L PA Primary
Emergency Medicine Physician 207P00000X MD069294L PA

Addresses

Primary practice location

25 Church St
Wilkes Barre, PA 18765-0999

Mailing address

PO Box 1347
Kingston, PA 18704-0347
Phone (570) 288-8881

Other practice location 1

239 S Mountain Blvd Ste 600
Mountain Top, PA 18707-1974
Phone (570) 474-5209

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
I20040602001423 PA Practitioner - Internal Medicine 2365424447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

812 Shoemaker Ave
West Wyoming, PA 18644-1120
Phone (570) 693-4020

Hospital & facility affiliations

  • Wilkes-Barre General Hospital Hospital, Wilkes-Barre, PA, CCN 390137
  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD069294LPAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Partners Internal Medicine CurrentSince Dec 1, 2007 Accepting new patients

Locations

239 S Mountain Blvd
Ste 600
Mountain Top, PA 18707
Phone (570) 474-5209

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

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 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1962476267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1347",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187040347",
            "telephone_number": "570-288-8881",
            "fax_number": "570-288-8065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CHURCH ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187650999",
            "telephone_number": "570-826-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "239 S Mountain Blvd Ste 600",
            "address_purpose": "LOCATION",
            "city": "Mountain Top",
            "state": "PA",
            "postal_code": "187071974",
            "country_code": "US",
            "telephone_number": "570-474-5209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADAJAR",
        "first_name": "MARIO",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD069294L",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD069294L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.