Laurie Elizabeth Healey – Family Nurse Practitioner

Key facts

NPI: 1992164065
Entity type: Individual (NPI type 1)
Primary specialty: Family Nurse Practitioner 363LF0000X
License: SP015931 (PA)
Practice address: 340 Montage Mountain Rd
Moosic, PA 18507-1782
Phone: (570) 346-3686
Fax: (570) 558-6838
NPI assigned: Feb 18, 2016
Sex: Female
Sole proprietor: Yes

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 and National Provider Directory roles.

Cleanslate Medical Group of Pennsylvania LLC Multi-Specialty Clinic/Center · Wilkes Barre, PA · NPI 1184177263

Medicare reassignment Care Compare group NPD PA

Medicare Care Compare profile

Specialty: Nurse Practitioner
Education: Other, 2014
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Telehealth: Offers telehealth services
Group practices: Cleanslate Medical Group of Pennsylvania LLC (20 clinicians)

Practice addresses (Care Compare)

1020 W Lackawanna Ave
Scranton, PA 18504-2052
Phone (413) 584-2173

Medicare participation

Medicare fee-for-service enrollment: Enrolled in PA
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20160330001554	PA	Practitioner - Nurse Practitioner	6406153808	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Bachelor on Science - Nursing, Nurse Practitioner

Practice roles

Organization	Specialty	Status	New patients
Cleanslate Medical Group of Pennsylvania LLC		Current since Mar 20, 2017	Accepting new patients

Locations

397 N 9th Ave
Scranton, PA 18504
Phone (570) 344-8619

1020 W Lackawanna Ave
Scranton, PA 18504
Phone (570) 290-4044

100 N Wilkes Barre Blvd
Ste 103
Wilkes Barre, PA 18702
Phone (570) 846-2720

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Nurse Practitioner	363LF0000X	SP015931	PA	Yes

Addresses

Primary practice location

340 Montage Mountain Rd
Moosic, PA 18507-1782

Mailing address

340 Montage Mountain Rd
Moosic, PA 18507-1782
Phone (570) 346-3686

Other names

Miss Laurie Elizabeth Mazur Former name

Other providers in Moosic, PA

Kon Soo Hahn, M.D.
Hamidian Training Institute
Ann Hart, LPC, CADC CRC
Theresa Ann Havel, PSY.D.
Edward Ryan Hayes, LCSW
Healing Hearts Counseling LLC
Jacob Herber, LPC
James Steven Hoban I, RPH
Jade Lynn Holley, PAC
Laurann Teresa Hoover, MA, LPC, NCC, LPC

All providers in Moosic, PA · Family Nurse Practitioner in Pennsylvania

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 10, 2016. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.