Active NPI
Ecaterina Iriza, M.D.
- Pediatrics Physician
- Wilkes Barre, PA
National Provider Identifier
1962494732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD068933L
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02098680 | Medicaid | NY | |
| 0017546950006 | Medicaid | PA | |
| 215035 | Other | NY | STATE LICENSE |
| ME129688 | Other | FL | FLORIDA 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME129688 | FL | MD | Pediatrics Physician |
| 215035 | NY | MD | Pediatrics Physician |
| MD068933L | PA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Caring Community Health Center | Current | Accepting new patients | |
| Caring Community Health Center | Current | Accepting new patients | |
| Caring Community Health Center | Current | 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
- 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.
-
- Federally Qualified Health Center (FQHC)
- Wilkes Barre, PA
- NPI 1679038293
-
- Federally Qualified Health Center (FQHC)
- Scranton, PA
- NPI 1891547964
-
- Federally Qualified Health Center (FQHC)
- Hazle Township, PA
- NPI 1902459407
-
- Hospitalist Physician
- Wilkes Barre, PA
- NPI 1588614358
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.