Individual provider Active NPI

Ecaterina Iriza, M.D.

  • Pediatrics Physician
  • Wilkes Barre, PA
National Provider Identifier
1962494732
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD068933L Issued in PA
Practice address
175 S Wilkes Barre Blvd
Wilkes Barre, PA 18702-5040
Phone
(570) 829-2621
NPI assigned
Aug 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME129688 FL
Pediatrics Physician 208000000X 215035 NY
Pediatrics Physician 208000000X MD068933L PA Primary

Addresses

Primary practice location

175 S Wilkes Barre Blvd
Wilkes Barre, PA 18702-5040

Mailing address

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

Other practice location 1

3100 SW 62nd Ave
Miami, FL 33155-3009
Phone (305) 666-6511

Other identifiers 4

IdentifierTypeStateIssuer
02098680MedicaidNY
0017546950006MedicaidPA
215035OtherNYSTATE LICENSE
ME129688OtherFLFLORIDA MEDICAL LICENSE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040915000735 PA Practitioner - Pediatric Medicine 2860469129 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME129688FLMDPediatrics Physician
215035NYMDPediatrics Physician
MD068933LPAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caring Community Health Center CurrentSince Apr 1, 2021 Accepting new patients
Caring Community Health Center Current Accepting new patients
Caring Community Health Center CurrentSince Apr 1, 2021 Accepting new patients
Geisinger Clinic Past Accepting new patients
Bon Secours Community Hospital Pediatrics 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

175 S Wilkes Barre Blvd
Wilkes Barre, PA 18702
Phone (570) 821-0808

Interoperability endpoints

  • Direct secure messaging: eiriza368144@direct.geisinger.edu

Organizations & group practices 5

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1962494732",
    "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": "175 S WILKES BARRE BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187025040",
            "telephone_number": "570-829-2621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 SW 62nd Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331553009",
            "country_code": "US",
            "telephone_number": "305-666-6511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IRIZA",
        "first_name": "ECATERINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2023-03-07",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME129688",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "215035",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD068933L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02098680",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017546950006",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "215035",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA MEDICAL LICENSE",
            "identifier": "ME129688",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.