DR. PAVEL PRIBULA M.D.
NPI 1043210628
Internal Medicine in Berwick, PA

Q: What is Pavel Pribula's NPI number?

The NPI number for Pavel Pribula is 1043210628. It was assigned to this individual provider in the NPPES registry on July 26, 2005.

Q: What is Pavel Pribula's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Pavel Pribula was last updated on October 8, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 26, 2005PECOS EnrolledAccepts Medicare Assignment

90.45/100

CMS Quality Rating

751 E 16TH ST, SUITE 300, BERWICK, PA 18603(570) 752-5056(570) 752-0841 Get Directions Write a Review

NPPES record last updated: October 8, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Pavel Pribula M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PAVEL PRIBULA M.D. (NPI 1043210628) is an individual internal medicine provider in Berwick, Pennsylvania, licensed in Pennsylvania (MD067594L) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Geisinger-bloomsburg Hospital, and is a graduate of Other (1988).

NPPES Registry Identity

NPI1043210628

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. PAVEL PRIBULACredential: M.D.

Location Address751 E 16TH ST, SUITE 300Berwick, PA 18603-2321

Mailing Address751 E 16th St, Suite 300Berwick, PA 18603-2321 · (570) 752-5056 · Fax (570) 752-0841

Phone(570) 752-5056

Fax(570) 752-0841

Sole ProprietorNo

Medical School CMSOtherGraduated 1988

Enumeration DateJuly 26, 2005

Last NPPES UpdateOctober 8, 2010

✔ NPI 1043210628 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in PA · MD067594L

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

751 E 16TH ST, Berwick, PA 18603

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Other Identifiers 13

Other160150PA · Keystone Health Plan Cent

Other002112PA · First Priority Health

OtherPR160150PA · Health One

OtherCQ88PA · Health America/health Ass

Medicare ID-Type Unspecified110213236PA · Medicare Railroad

Other01089801PA · Capital Blue Cross

Medicare ID-Type Unspecified026631SMXPA

Other160150PA · Highmark

OtherP006026PA · Gateway Health Plan

Medicare UPING91545PA

Medicare ID-Type Unspecified010093500PA · Black Lung - Medicare

Medicaid001794117/0004PA

Other48130PA · Geisinger Health Plan

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Pavel Pribula M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8325940075

PECOS Enrollment IDI20040122001087

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 19

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

356 services182 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

328 services188 patients

Anticoagulant management of patient taking warfarin 93793

Anticoagulant management with warfarin involves monitoring and adjusting your medication to prevent blood clots while minimizing the risk of bleeding. Regular blood tests measure your response to warfarin, helping adjust your dose if necessary. It's crucial to maintain a consistent diet and promptly report any changes in your health.

204 services17 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

166 services166 patients

Blood test, clotting time 85610

A clotting time blood test helps determine how quickly your blood forms clots, a process crucial to stop bleeding. During the test, a small blood sample is taken from your arm. The sample is then analyzed in a lab to see how long it takes for a clot to form.

164 services11 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

114 services114 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

108 services106 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

99 services98 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

99 services99 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

98 services24 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

80 services57 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

61 services22 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

35 services21 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

33 services30 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

26 services26 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

24 services20 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

23 services22 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

15 services14 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

12 services11 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Geisinger-Bloomsburg Hospital

Acute Care Hospitals · Bloomsburg, PA

OwnershipVoluntary non-profit - Private

CMS Certification Number390003

Location549 East Fair StreetBloomsburg, PA 17815 · Columbia County

Emergency services Birthing friendly

Geisinger Medical Center

Acute Care Hospitals · Danville, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390006

Location100 North Academy AvenueDanville, PA 17822 · Montour County

Emergency services Birthing friendly

Wilkes-Barre General Hospital

Acute Care Hospitals · Wilkes-Barre, PA

1/5 CMS rating

OwnershipProprietary

CMS Certification Number390137

Location575 North River StreetWilkes-Barre, PA 18764 · Luzerne County

Emergency services

Lehigh Valley Hospital - Hazleton

Acute Care Hospitals · Hazleton, PA

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number390185

Location700 East Broad StreetHazleton, PA 18201 · Luzerne County

Emergency services Birthing friendly

Geisinger Wyoming Valley Medical Center

Acute Care Hospitals · Wilkes Barre, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390270

Location1000 East Mountain BoulevardWilkes Barre, PA 18711 · Luzerne County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18603 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$126.34 typical visit price

range $54.64 – $166.87

Typical copayment $31.58 (range $13.66 – $41.71)

Most-billed visit code 99204

Established Patient

$96.82 typical visit price

range $17.33 – $135.84

Typical copayment $24.20 (range $4.33 – $33.96)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

90.45/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

80.91

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

14 suppliers130 claims211 services$5.51 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

7 suppliers38 claims39 services$0.98 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

4 suppliers41 claims41 services$15.94 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

4 suppliers41 claims41 services$81.54 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

4 suppliers25 claims25 services$186.40 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ALVA D SMITH MD

Internal Medicine (Cardiovascular Disease)

751 E 16TH ST, SUITE 200
BERWICK, PA 18603

Columbia County (570) 759-5491

DR. FRANK GEGWICH M.D.

Internal Medicine

751 E 16TH ST, SUITE 400
BERWICK, PA 18603

Columbia County (570) 752-5056

BERWICK CLINIC COMPANY LLC

Family Medicine

751 E 16TH ST, SUITE 400
BERWICK, PA 18603

Columbia County (505) 759-5555

BERWICK MEDICAL PROFESSIONALS PC

Clinic/Center

751 E 16TH ST
BERWICK, PA 18603

Columbia County (570) 759-5555

INTERNAL MEDICINE OF BERWICK PC INC

Internal Medicine

751 E 16TH ST, SUITE300
BERWICK, PA 18603

Columbia County (570) 752-5056

ALVA D SMITH MD PC

Internal Medicine (Cardiovascular Disease)

751 E 16TH ST, SUITE 200
BERWICK, PA 18603

Columbia County (570) 759-5491

MRS. TIFFANY LYNN JENSEN MHA, MBA

Clinic/Center (Primary Care)

751 E 16TH ST
BERWICK, PA 18603

Columbia County (570) 294-2095

WOMENS HEALTHCARE PROFESSIONALS PC

Obstetrics & Gynecology

751 E 16TH ST, SUITE 100
BERWICK, PA 18603

Columbia County (570) 759-8050

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pavel Pribula's NPI number?

The NPI number for Pavel Pribula is 1043210628. It was assigned to this individual provider in the NPPES registry on July 26, 2005.

Where is Pavel Pribula located?

Pavel Pribula practices at 751 E 16th St Suite 300, Berwick, PA 18603. The listed phone number is (570) 752-5056.

What is Pavel Pribula's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Pavel Pribula enrolled in Medicare?

Yes. Pavel Pribula is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Pavel Pribula affiliated with any hospitals?

According to CMS data, Pavel Pribula is affiliated with Geisinger-Bloomsburg Hospital, Geisinger Medical Center, Wilkes-Barre General Hospital, Lehigh Valley Hospital - Hazleton and Geisinger Wyoming Valley Medical Center.

When was this NPI record last updated?

The NPPES record for Pavel Pribula was last updated on October 8, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.