Active NPI
Mario J Sebastianelli, MD
- Nephrology Physician
- Dunmore, PA
National Provider Identifier
1972501872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- MD0006983E
- Practice address
- 1416 Monroe Ave
Ste 206
Dunmore, PA 18509-2477 - Phone
- (570) 347-5212
- Fax
- (570) 346-4814
- NPI assigned
- Jul 13, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | MD0006983E | PA | Primary |
| Nephrology Physician | 207RN0300X | ME-11834 | FL |
Addresses
Primary practice location
1416 Monroe Ave
Ste 206
Dunmore, PA 18509-2477
Mailing address
1416 Monroe Ave
Ste 206
Dunmore, PA 18509-2477
Phone (570) 347-5212
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0669080 | Medicaid | PA |
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
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- Jefferson Medical College of Thomas Jefferson University, 1962
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1416 Monroe Ave
Suite 206
Dunmore, PA 18509-2477
Phone (570) 347-5212
Hospital & facility affiliations
- DaVita Dunmore Dialysis
- Geisinger-Community Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME-11834 | FL | MD | Nephrology Physician |
| MD0006983E | PA | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mario J. Sebastianelli, MD PC | Nephrology | Current | Accepting new patients |
| Geisinger Clinic | Past | Accepting new patients |
Locations
1416 Monroe Ave
Ste 206
Scranton, PA 18509
Phone (570) 347-5212
Organizations & group practices 2
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.
-
- Nephrology Physician
- Dunmore, PA
- NPI 1194723007
-
- Hospitalist Physician
- Wilkes Barre, PA
- NPI 1588614358
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Endocrinology, Diabetes & Metabolism Physician
- Scranton, PA
- NPI 1306439856
Hospital
-
- General Acute Care Hospital
- Scranton, PA
- NPI 1366444507
-
- General Acute Care Hospital
- Scranton, PA
- NPI 1972652063
-
- Diagnostic Radiology Physician
- Scranton, PA
- NPI 1467850149
Hospital
-
- Radiology Clinic/Center
- Scranton, PA
- NPI 1548648272
Hospital
-
- Radiology Clinic/Center
- Scranton, PA
- NPI 1124405592
Hospital
-
- Physical Therapy Clinic/Center
- Scranton, PA
- NPI 1336526276
Hospital
-
- Sleep Disorder Diagnostic Clinic/Center
- Scranton, PA
- NPI 1417334350
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186012800000",
"number": "1972501872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1416 MONROE AVE",
"address_2": "STE 206",
"city": "DUNMORE",
"state": "PA",
"postal_code": "185092477",
"telephone_number": "570-347-5212",
"fax_number": "570-346-4814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1416 MONROE AVE",
"address_2": "STE 206",
"city": "DUNMORE",
"state": "PA",
"postal_code": "185092477",
"telephone_number": "570-347-5212",
"fax_number": "570-346-4814"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEBASTIANELLI",
"first_name": "MARIO",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-13",
"last_updated": "2007-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "PA",
"license": "MD0006983E",
"primary": true
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "FL",
"license": "ME-11834",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0669080",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dunmore, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.