Unknown Individual – Family Medicine Physician, NPI 1124059464
Family Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Loading map...
Provider Addresses for Unknown Individual
315, South Main Street, Lawrenceville, Old Forge, Lackawanna County, Pennsylvania, 18518, United States
OLD FORGE, PA 185181606
Phone: (570) 457-8364
Fax: (570) 457-9635
Type: Mailing
1400 MAIN ST
PECKVILLE, PA 184522081
Phone: (570) 307-7600
Fax: (570) 383-5594
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 13 | 12 | $0 |
Insurance plans in this area (ZIP 18518)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Vascular Surgery, Peripheral Vascular Disease | PA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | PA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | PA | |
| - | NY | |
| General Surgery | PA | |
| - | PA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | PA | |
| - | PA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | PA | |
| Internal Medicine, Hospitalist | PA |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.