Unknown Individual – Clinical Cardiac Electrophysiology Physician, NPI 1578723979

Clinical Cardiac Electrophysiology Physician

Unknown Individual is a healthcare provider. based in Danville, Pennsylvania. specializing in Clinical Cardiac Electrophysiology Physician. They hold a License No. MD459092 (PA). The NPI Number for Unknown Individual is 1578723979

Main info

Organization

Inactive

19 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1578723979

Phone

(570) 271-6144

Address

100 NORTH ACADEMY AVE

Deactivation Date

11 January 2023

Doctor Profile

Medical School Name

NEW YORK MEDICAL COLLEGE

Secondary Phone

5709612105

Graduation Year

2007 (19 years ago)

PAC ID

4486942588

Group Practice PAC ID

5395657001

Professional Enrollment ID

I20161005001020

Contacts

Secure Messaging

wyoung137883@direct.geisinger.edu

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

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
DANVILLE, PA 178224903
Phone: (570) 271-6144
Fax: (570) 271-6578
Type: Mailing
Geisinger Community Medical Center, 1800, Mulberry Street, Scranton, Lackawanna County, Pennsylvania, 18510, United States
SCRANTON, PA 185102369
Phone: (570) 703-4830
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.

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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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Provider's Procedures

Unknown Individual performs procedures in Clinical Cardiac Electrophysiology Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
CARDIAC ELECTROPHYSIOLOGY	PA	93010	Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report	67	58
CARDIAC ELECTROPHYSIOLOGY	PA	93280	Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report	73	70
CARDIAC ELECTROPHYSIOLOGY	PA	93284	Evaluation, testing and programming adjustment of defibrillator with analysis, review and report	21	20

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

What is Unknown Individual's NPI number?

Unknown Individual's NPI is 1578723979 — the number used across U.S. healthcare to identify this provider.

Is inactive the same as retired for Unknown Individual?

Inactive registry status can reflect deactivation, consolidation, or data lag.

What kind of doctor is Unknown Individual?

Unknown Individual is associated with Clinical Cardiac Electrophysiology Physician in the directory — Clinical services aligned with this taxonomy classification.

Where in Pennsylvania is Unknown Individual registered?

Use Danville, Pennsylvania as the headline location for Unknown Individual here.

When was this NPI issued?

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