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GEISINGER WYOMING VALLEY MEDICAL CENTER
NPI 1104624246
Clinic/Center in Dickson City, PA

Active since March 05, 2025
703 MARTIN F GIBBONS BLVD, DICKSON CITY, PA 18519(570) 846-2340(570) 846-2341 Get Directions Write a Review

NPPES record last updated: July 24, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 24, 2026, Jun 11, 2025, Mar 5, 2025 (3 updates tracked since 2025).

About Geisinger Wyoming Valley Medical Center NPPES

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

GEISINGER WYOMING VALLEY MEDICAL CENTER (NPI 1104624246) is a healthcare organization registered as a clinic/center in Dickson City, Pennsylvania and active in the NPI registry since March 2025. The organization lists Will Xenakis, System Director Credentialing, as its authorized official.

NPPES Registry Identity

NPI1104624246
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameGEISINGER WYOMING VALLEY MEDICAL CENTER
Location Address703 MARTIN F GIBBONS BLVDDickson City, PA 18519-1787
Mailing Address100 N Academy AveDanville, PA 17822-4903 · (570) 271-6144 · Fax (570) 271-6578
Phone(570) 846-2340
Fax(570) 846-2341
Organization SubpartNo
Authorized OfficialWill XenakisSystem Director Credentialing · (516) 661-8959
Enumeration DateMarch 5, 2025
Last NPPES UpdateJuly 24, 20263 updates tracked since enumeration
NPPES CertifiedJuly 24, 2026
✔ NPI 1104624246 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Also ListedGeneral Acute Care HospitalTaxonomy 282N00000X
703 MARTIN F GIBBONS BLVD, Dickson City, PA 18519
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Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Geisinger Wyoming Valley Medical Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StatePennsylvaniaEnrollment IDO20040901000618Part A · HospitalDue dateFebruary 28, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Other Providers at the Same Location NPPES 7

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

DR. ANURAG SHARMA M.D.
Internal Medicine (Medical Oncology)
703 MARTIN F GIBBONS BLVD
SCRANTON, PA 18519
Lackawanna County (570) 846-2340
IRFAN SHAUKAT MD
Internal Medicine (Hematology & Oncology)
703 MARTIN F GIBBONS BLVD
DICKSON CITY, PA 18519
Lackawanna County (570) 846-2340
NIRIKSHA MADANLAL CHANDRANI M.D.
Internal Medicine (Hematology & Oncology)
703 MARTIN F GIBBONS BLVD
DICKSON CITY, PA 18519
Lackawanna County (570) 846-2340
KRYSTINA ALEXIS DOWNS
Physician Assistant
703 MARTIN F GIBBONS BLVD
DICKSON CITY, PA 18519
Lackawanna County (570) 846-2340
HAYAN MOUALLA MD
Internal Medicine (Hematology & Oncology)
703 MARTIN F GIBBONS BLVD
DICKSON CITY, PA 18519
Lackawanna County (570) 846-2340
OTASOWIE MICHAEL ODIASE
Radiology (Radiation Oncology)
703 MARTIN F GIBBONS BLVD
DICKSON CITY, PA 18519
Lackawanna County (570) 846-2340
HESHAM MOHAMED TAHA M.D.
Internal Medicine (Hematology & Oncology)
703 MARTIN F GIBBONS BLVD
DICKSON CITY, PA 18519
Lackawanna County (570) 846-2340

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 Geisinger Wyoming Valley Medical Center's NPI number?

The NPI number for Geisinger Wyoming Valley Medical Center is 1104624246. It was assigned to this organization in the NPPES registry on March 5, 2025.

Where is Geisinger Wyoming Valley Medical Center located?

Geisinger Wyoming Valley Medical Center is located at 703 Martin F Gibbons Blvd, Dickson City, PA 18519. The listed phone number is (570) 846-2340.

What is Geisinger Wyoming Valley Medical Center's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Geisinger Wyoming Valley Medical Center enrolled in Medicare?

Yes. Geisinger Wyoming Valley Medical Center is registered in the Medicare PECOS enrollment system.

When is Geisinger Wyoming Valley Medical Center's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Part A enrollment for this organization (Pennsylvania, Hospital) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

When was this NPI record last updated?

The NPPES record for Geisinger Wyoming Valley Medical Center was last updated on July 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.