CLEANSLATE MEDICAL GROUP OF PENNSYLVANIA LLC
NPI 1184177263
Clinic/Center - Multi-Specialty in Wilkes Barre, PA

Active since July 26, 2016
100 N WILKES BARRE BLVD STE 103, WILKES BARRE, PA 18702(413) 584-2173(833) 279-7074 Get Directions Write a Review

NPPES record last updated: December 17, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 17, 2025, May 8, 2025, Jul 3, 2024 and 5 more (8 updates tracked since 2017).

About Cleanslate Medical Group Of Pennsylvania Llc NPPES

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

CLEANSLATE MEDICAL GROUP OF PENNSYLVANIA LLC (NPI 1184177263) is a healthcare organization registered as a multi-specialty in Wilkes Barre, Pennsylvania and active in the NPI registry since July 2016. The organization lists Matthew Philip Smolarek, Cfo, as its authorized official.

NPPES Registry Identity

NPI1184177263
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameCLEANSLATE MEDICAL GROUP OF PENNSYLVANIA LLC
Location Address100 N WILKES BARRE BLVD STE 103Wilkes Barre, PA 18702-5240
Mailing Address8 Cadillac Dr Ste 300Brentwood, TN 37027-5337 · (615) 425-0220 · Fax (833) 279-7074
Fax(833) 279-7074
Organization SubpartNo
Authorized OfficialMatthew Philip SmolarekCfo · (412) 999-5188
Enumeration DateJuly 26, 2016
Last NPPES UpdateDecember 17, 20258 updates tracked since enumeration
NPPES CertifiedDecember 17, 2025
NPI 1184177263 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
Also ListedInternal Medicine · Addiction MedicineTaxonomy 207RA0401X
100 N WILKES BARRE BLVD STE 103, Wilkes Barre, PA 18702

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Other Providers at the Same Location NPPES 12

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

Counselor (Addiction (Substance Use Disorder))
100 N WILKES BARRE BLVD STE 103
WILKES BARRE, PA 18702
Obstetrics & Gynecology
100 N WILKES BARRE BLVD STE 103
WILKES BARRE, PA 18702
Peer Specialist
100 N WILKES BARRE BLVD STE 103
WILKES BARRE, PA 18702
Peer Specialist
100 N WILKES BARRE BLVD STE 103
WILKES BARRE, PA 18702
Nurse Practitioner (Family)
100 N WILKES BARRE BLVD STE 103
WILKES BARRE, PA 18702
Peer Specialist
100 N WILKES BARRE BLVD STE 103
WILKES BARRE, PA 18702
Nurse Practitioner (Family)
100 N WILKES BARRE BLVD STE 103
WILKES BARRE, PA 18702
Peer Specialist
100 N WILKES BARRE BLVD STE 103
WILKES BARRE, PA 18702

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 Cleanslate Medical Group Of Pennsylvania LLC's NPI number?

The NPI number for Cleanslate Medical Group Of Pennsylvania LLC is 1184177263. It was assigned to this organization in the NPPES registry on July 26, 2016.

Where is Cleanslate Medical Group Of Pennsylvania LLC located?

Cleanslate Medical Group Of Pennsylvania LLC is located at 100 N Wilkes Barre Blvd Ste 103, Wilkes Barre, PA 18702. The listed phone number is (413) 584-2173.

What is Cleanslate Medical Group Of Pennsylvania LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

What insurance does Cleanslate Medical Group Of Pennsylvania LLC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Buckeye Health Plan and CareSource list Cleanslate Medical Group Of Pennsylvania LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Cleanslate Medical Group Of Pennsylvania LLC was last updated on December 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.