NPIMap

Individual provider Active NPI

Duane E. Deivert, D.O.

  • Gastroenterology Physician
  • Wilkes Barre, PA
National Provider Identifier
1992771158
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
OS012660 Issued in PA
Practice address
675 Baltimore Dr
Wilkes Barre, PA 18702-7900
Phone
(570) 808-5757
Fax
(570) 808-5753
NPI assigned
Feb 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X OS012660 PA
Gastroenterology Physician 207RG0100X OS012660 PA Primary

Addresses

Primary practice location

675 Baltimore Dr
Wilkes Barre, PA 18702-7900

Mailing address

100 N Academy Ave
Danville, PA 17822-3034
Phone (570) 271-6144

Other identifiers 1

IdentifierTypeStateIssuer
101355085MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ddeivert78083@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
I20050818000072 PA Practitioner - Internal MedicinePractitioner - Gastroenterology 7012947187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Gastroenterology
Education
Philadelphia College of Osteopathic Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

675 Baltimore Dr
Wilkes Barre, PA 18702-7900
Phone (570) 826-7300

Hospital & facility affiliations

  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270
  • Geisinger-Community Medical Center Hospital, Scranton, PA, CCN 390001
  • Geisinger St. Luke'S Hospital Hospital, Orwigsburg, PA, CCN 390332
  • Geisinger Medical Center Hospital, Danville, PA, CCN 390006

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy103
Upper gastrointestinal (GI) endoscopy for acid reflux112

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS012660PAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Jun 1, 2009 Accepting new patients
Geisinger Clinic CurrentSince Jun 1, 2009 Accepting new patients
Geisinger Clinic Hospitalist Past Accepting new patients

Locations

42 N Scott St
Carbondale, PA 18407
Phone (570) 282-6660

100 N Academy Ave
Danville, PA 17822

675 Baltimore Dr
Wilkes Barre, PA 18702
Phone (570) 808-5757

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

1000 E Mountain Blvd
Wilkes Barre, PA 18711
Phone (570) 808-7399

Interoperability endpoints

  • Direct secure messaging: ddeivert78083@direct.geisinger.edu

Organizations & group practices 4

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 57

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

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1992771158",
    "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": "178223034",
            "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": "675 BALTIMORE DR",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187027900",
            "telephone_number": "570-808-5757",
            "fax_number": "570-808-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEIVERT",
        "first_name": "DUANE",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "OS012660",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "OS012660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101355085",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ddeivert78083@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "675 Baltimore Dr",
            "city": "Wilkes Barre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187027900",
            "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.