NPIMap

Individual provider Active NPI

Elizabeth Gernhardt, DO

  • Family Medicine Physician
  • Forty Fort, PA
National Provider Identifier
1972580405
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS009873L Issued in PA
Practice address
1732 Wyoming Ave
Forty Fort, PA 18704-4340
Phone
(570) 331-9134
Fax
(570) 331-9171
NPI assigned
Dec 27, 2005
Last updated
Jan 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS009873L PA Primary

Addresses

Primary practice location

1732 Wyoming Ave
Forty Fort, PA 18704-4340

Mailing address

PO Box 1048
Kingston, PA 18704-0048
Phone (570) 331-9134

Other identifiers 1

IdentifierTypeStateIssuer
001804821MedicaidPA

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
I20100513001033 PA Practitioner - Family Practice 4082742978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1732 Wyoming Ave
Forty Fort, PA 18704-4340
Phone (570) 331-9134

200 S Meade St
Wilkes Barre, PA 18702-6221
Phone (570) 823-6131

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
29.67 of 100Reported as individual
Quality
20
Improvement activities
0
Cost
72.23

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Elizabeth a. Gernhardt Inc. Family Medicine CurrentSince Oct 5, 1998 Accepting new patients

Locations

1732 Wyoming Ave
Forty Fort, PA 18704
Phone (570) 287-6930

920 Wyoming Ave
Ste 202
Forty Fort, PA 18704
Phone (570) 331-9134

Interoperability endpoints

  • Direct secure messaging: elizabeth.gernhardt@eagi-pa.direct.office.nextgen.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1972580405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1048",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187040048",
            "telephone_number": "570-331-9134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1732 WYOMING AVE",
            "city": "FORTY FORT",
            "state": "PA",
            "postal_code": "187044340",
            "telephone_number": "570-331-9134",
            "fax_number": "570-331-9171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERNHARDT",
        "first_name": "ELIZABETH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-27",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS009873L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001804821",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forty Fort, PA

Sources for this page

Verify at the official NPI Registry.