MIRIAM CAROLINE OMALLEY (DMD) – Oral and Maxillofacial Surgery (Dentist), NPI 1154419042

MIRIAM CAROLINE OMALLEY (DMD) is a healthcare provider. based in Kingston, Pennsylvania. specializing in ORAL SURGERY. They hold the professional credentials DMD. They hold a License No. 027676L (PA). The NPI Number for MIRIAM CAROLINE OMALLEY (DMD) is 1154419042

Main info

Female
36 Years Of Experience
Accepts Medicare Assignment
Name
MIRIAM CAROLINE OMALLEY (DMD)
NPI
1154419042
Phone
(570) 288-9070
Address
550 3RD AVE
Enumeration Date
10 October 2006
Last Update Date
10 October 2013

Doctor Profile

Medical School Name
PERELMAN SCHOOL OF MED AT THE UNIVERSITY OF PENNSYLVANIA
Secondary Phone
5702889070
Graduation Year
1990 (36 years ago)
PAC ID
3577520428
Group Practice PAC ID
4981053048
Professional Enrollment ID
I20050110000072
Address ID
PA187045806KI550XXAVEX302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

172 ORAL SURGERY in PA

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Provider Addresses for MIRIAM CAROLINE OMALLEY (DMD)

  • 550, 3rd Avenue, Kingston, Luzerne County, Pennsylvania, 18704, United States

    STE 1

    KINGSTON, PA 187045806

    Phone: (570) 288-9070

    Fax: (570) 288-4201

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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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.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-01-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050110000072IOral SurgeryPATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
70355X-ray of lower jaws, upper jaws and teeth2321$0
99203New patient office or other outpatient visit, 30-44 minutes2020$0
View full utilization report →

Insurance plans in this area (ZIP 18704)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4981053048View full group profile
NameSpecialtyState
Oral SurgeryPA
Oral SurgeryPA
Oral SurgeryPA

Reviews

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Frequently asked questions

Where can patients find MIRIAM CAROLINE OMALLEY (DMD)'s NPI?
You can confirm MIRIAM CAROLINE OMALLEY (DMD) with NPI 1154419042; it appears in the national provider directory.
Is MIRIAM CAROLINE OMALLEY (DMD)'s NPI currently valid?
The extract we use shows MIRIAM CAROLINE OMALLEY (DMD) as active.
What field does MIRIAM CAROLINE OMALLEY (DMD) work in?
You can think of MIRIAM CAROLINE OMALLEY (DMD) as practicing within Oral and Maxillofacial Surgery (Dentist). Clinical services aligned with this taxonomy classification.
Does MIRIAM CAROLINE OMALLEY (DMD) practice in Pennsylvania?
You will see Kingston, Pennsylvania on file for MIRIAM CAROLINE OMALLEY (DMD) alongside any extra practice locations.
Is MIRIAM CAROLINE OMALLEY (DMD) a real provider?
This page reflects official NPPES data for NPI 1154419042. Always confirm identity and privileges with the practice and licensing boards.

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