Unknown Individual – Surgical Critical Care Physician, NPI 1285690164

Surgical Critical Care Physician

Unknown Individual is a healthcare provider. based in Danville, Pennsylvania. specializing in Surgical Critical Care Physician. They hold a License No. MD028144E (PA). The NPI Number for Unknown Individual is 1285690164

Main info

Organization

Inactive

46 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1285690164

Phone

(570) 271-6144

Address

100 N ACADEMY AVE

Deactivation Date

31 May 2023

Doctor Profile

Medical School Name

TEMPLE UNIVERSITY SCHOOL OF MEDICINE

Secondary Phone

5708267850

Graduation Year

1980 (46 years ago)

PAC ID

6204852593

Group Practice PAC ID

5395657001

Professional Enrollment ID

I20051017000220

Contacts

Secure Messaging

ftoy66630@direct.geisinger.edu

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience19

Completeness85

Years active:0State licenses:1Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

Geisinger Medical Center Danville, 100, North Academy Avenue, Danville, Montour County, Pennsylvania, 17822, United States
CREDENTIALS DEPT
DANVILLE, PA 178224903
Phone: (570) 271-6144
Type: Mailing
Geisinger Wyoming Valley Medical Center, 1000, East Mountain Boulevard, Fox Hill, Wilkes-Barre, Luzerne County, Pennsylvania, 18711, United States
WILKES BARRE, PA 187110027
Phone: (570) 808-2340
Fax: (570) 808-7904
Type: Location

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.

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 17822)

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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: 5395657001View full group profile

Name	Specialty	State
DR. KEVIN P BURKHARDT	-	NC
FRANCIS LIM (MD)	-	PA
DR. GERALDINE ORENDAIN (M.D.)	P S Y C H I A T R Y	NY
PATRICK KILDUFF (D.O.)	Internal Medicine, Hospice/Palliative Care	PA
DR. STANLEY JOSEPH RUSSIN (M.D.)	-	PA
MS. KELLY R. HAIKES (CRNP)	Nurse Practitioner	PA
MRS. KIMBERLY ANN REED (PAC)	Physician Assistant	PA
DR. MICHAEL LAWRENCE ROBINSON (M.D.)	-	PA
MRS. LISBETH A TURNER (CRNP)	-	PA
MEGAN W HARRIS (PA-C)	Physician Assistant	PA

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1285690164?

NPI 1285690164 belongs to Unknown Individual; compare other details if you need extra assurance.

Is Unknown Individual still active if the NPI shows inactive?

NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.

What clinical focus is listed for Unknown Individual?

At a glance, Unknown Individual is tied to Surgical Critical Care Physician. Clinical services aligned with this taxonomy classification.

Is Unknown Individual located near Danville?

Unknown Individual currently maps to Danville, Pennsylvania in this extract.

When was this NPI issued?

Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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