NPIMap

Individual provider Active NPI

Armando R Sallavanti, DO

  • Family Medicine Physician
  • Old Forge, PA
National Provider Identifier
1982672523
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS009292L Issued in PA
Practice address
315 S Main St
Old Forge, PA 18518-1606
Phone
(570) 457-8364
Fax
(570) 457-9635
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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 OS009292L PA Primary

Addresses

Primary practice location

315 S Main St
Old Forge, PA 18518-1606

Mailing address

315 S Main St
Old Forge, PA 18518-1606
Phone (570) 457-8364

Other identifiers 1

IdentifierTypeStateIssuer
001688188MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address armando.sallavanti.1@21771.direct.athenahealth.com

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
I20050523000615 PA Practitioner - Family Practice 5496797201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

315 S Main St
Old Forge, PA 18518-1606
Phone (570) 457-8364

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.17 of 100Reported as apm
Quality
78.34
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS009292LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scranton Quincy Clinic Company LLC Family Medicine CurrentSince Jan 1, 2012 Accepting new patients
Physicians Health Alliance Inc Past Accepting new patients
Old Forge Chiropractic & Rehabilitation, P.C. PastSince Aug 2, 1999 Accepting new patients

Locations

150 Brooklyn St
Carbondale, PA 18407
Phone (570) 282-2031

315 S Main St
Old Forge, PA 18518
Phone (570) 457-8364

1401 Electric St
Scranton, PA 18509
Phone (570) 770-5929

Organizations & group practices 3

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 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1982672523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 S MAIN ST",
            "city": "OLD FORGE",
            "state": "PA",
            "postal_code": "185181606",
            "telephone_number": "570-457-8364",
            "fax_number": "570-457-9635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S MAIN ST",
            "city": "OLD FORGE",
            "state": "PA",
            "postal_code": "185181606",
            "telephone_number": "570-457-8364",
            "fax_number": "570-457-9635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALLAVANTI",
        "first_name": "ARMANDO",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS009292L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001688188",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "armando.sallavanti.1@21771.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "amrdirectaddress",
            "address_1": "315 S Main St",
            "city": "Old Forge",
            "state": "PA",
            "country_code": "US",
            "postal_code": "185181606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Old Forge, PA

Sources for this page

Verify at the official NPI Registry.