NPIMap

Individual provider Active NPI

Alexander M Piczon, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Wilkes Barre, PA
National Provider Identifier
1992756704
Registry record updated May 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA052371 Issued in PA
Practice address
1175 E Mountain Blvd
Wilkes Barre, PA 18702-7906
Phone
(570) 808-1093
Fax
(570) 808-7878
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA052371 PA Primary
Surgical Physician Assistant 363AS0400X MA052371 PA

Addresses

Primary practice location

1175 E Mountain Blvd
Wilkes Barre, PA 18702-7906

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address apiczon83425@direct.geisinger.edu Direct

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
I20060823000457 PA Practitioner - Physician Assistant 3476556960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
H2 Health and Rehabilitation Services LLCGroup PAC ID 3678880234, 41 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

1000 E Mountain Dr
Wilkes Barre, PA 18711-0027
Phone (570) 826-7300

114 LT Michael Cleary Dr
Dallas, PA 18612-1649
Phone (570) 255-1178

1155 E Mountain Blvd
Wilkes Barre, PA 18702-7906
Phone (570) 808-5135

1175 E Mountain Blvd
Suite 150723
Wilkes Barre, PA 18702-7906
Phone (570) 808-1093

1800 Mulberry St
Scranton, PA 18510-2369
Phone (570) 969-7355

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

25 Church St
Wilkes Barre, PA 18702-3507
Phone (570) 808-3181

506 Hazle St
Wilkes Barre, PA 18702-4646
Phone (570) 270-4366

Hospital & facility affiliations

  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270
  • Geisinger-Community Medical Center Hospital, Scranton, PA, CCN 390001
  • John Heinz Institute of Rehabilitation Medicine Inpatient rehabilitation facility, Wilkes Barre Townshi, PA, CCN 393036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA052371PAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Physician Assistant CurrentSince Apr 1, 2008 Accepting new patients
Geisinger Clinic CurrentSince Apr 1, 2008 Accepting new patients
Geisinger Clinic Past Accepting new patients
Orthopaedic Consultants of Wyoming Valley LLC Past Accepting new patients

Locations

226 Buckaroo Ln
Bellefonte, PA 16823
Phone (814) 353-1030

100 N Academy Ave
Danville, PA 17822

955 Bellefonte Ave
Lock Haven, PA 17745
Phone (570) 748-7714

1201 Oak St
Pittston, PA 18640
Phone (570) 808-9800

1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300

Interoperability endpoints

  • Direct secure messaging: apiczon83425@direct.geisinger.edu

Organizations & group practices 6

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 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651795200000",
    "number": "1992756704",
    "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": "1175 E MOUNTAIN BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187027906",
            "telephone_number": "570-808-1093",
            "fax_number": "570-808-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICZON",
        "first_name": "ALEXANDER",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA052371",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA052371",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apiczon83425@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1175 E Mountain Blvd",
            "city": "Wilkes Barre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187027906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.