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DR. ROBERT A SCALIA D.O.
NPI 1225021439
Internal Medicine in Pine Grove, PA

Active since August 24, 2005PECOS EnrolledAccepts Medicare Assignment
35 TREMONT RD, PINE GROVE, PA 17963(570) 915-6497(570) 915-6631 Get Directions Write a Review

NPPES record last updated: January 30, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Robert A Scalia D.o. NPPES

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

DR. ROBERT A SCALIA D.O. (NPI 1225021439) is an individual internal medicine provider in Pine Grove, Pennsylvania, licensed in Pennsylvania (OS007750L) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Schuylkill Medical Center - South Jackson Street, and is a graduate of Philadelphia College Of Osteopathic Medicine (1996).

NPPES Registry Identity

NPI1225021439
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. ROBERT A SCALIACredential: D.O.
Location Address35 TREMONT RDPine Grove, PA 17963-8629
Mailing Address35 Tremont RdPine Grove, PA 17963-8629 · (570) 915-6497 · Fax (570) 915-6631
Phone(570) 915-6497
Fax(570) 915-6631
Sole ProprietorNo
Medical School CMSPhiladelphia College Of Osteopathic MedicineGraduated 1996
Enumeration DateAugust 24, 2005
Last NPPES UpdateJanuary 30, 2015
✔ NPI 1225021439 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in PA · OS007750L
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.
Also ListedPediatricsTaxonomy 208000000X · License OS007750L (PA)
35 TREMONT RD, Pine Grove, PA 17963
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Other Identifiers 6

Medicare PIN731411PA
Other368453PA · Medicare Group Ptan#
Medicaid0016281070008PA
OtherDV1944Railroad Medicare Group Ptan
Medicare UPING24113PA
OtherP01395482Railroad Medicare Provider Ptan

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

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. Robert A Scalia D.o. 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 ID4880637347
PECOS Enrollment IDI20050606000672
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 9

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.
447 services145 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
258 services114 patients
Assessment of emotional or behavioral problems 96127
Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.
181 services66 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.
141 services81 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.
109 services109 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.
43 services41 patients

Hospital Affiliations CMS Care Compare 3

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

Schuylkill Medical Center - South Jackson Street

Acute Care Hospitals · Pottsville, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390030
Location420 South Jackson StreetPottsville, PA 17901 · Schuylkill County
Emergency services Birthing friendly

Wellspan Good Samaritan Hospital

Acute Care Hospitals · Lebanon, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390066
Location252 South 4th StreetLebanon, PA 17042 · Lebanon County
Emergency services Birthing friendly

Geisinger St. Luke's Hospital

Acute Care Hospitals · Orwigsburg, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390332
Location100 Paramount BoulevardOrwigsburg, PA 17961 · Schuylkill County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 17963 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.

Reported Quality Measures

Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
32%894 patients2/55-star benchmark: 88%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 231 patients
0%231 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 13

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
5 suppliers13 claims30 services$5.50 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
6 suppliers21 claims21 services$105.12 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
6 suppliers25 claims56 services$39.89 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
8 suppliers16 claims16 services$21.96 avg. paid by Medicare
Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
7 suppliers21 claims21 services$18.98 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
8 suppliers29 claims144 services$2.57 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

SCALIA PRIMARY CARE PC
Internal Medicine
35 TREMONT RD
PINE GROVE, PA 17963
Schuylkill County (570) 691-5277

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 Robert Scalia's NPI number?

The NPI number for Robert Scalia is 1225021439. It was assigned to this individual provider in the NPPES registry on August 24, 2005.

Where is Robert Scalia located?

Robert Scalia practices at 35 Tremont Rd, Pine Grove, PA 17963. The listed phone number is (570) 915-6497.

What is Robert Scalia's specialty?

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

Is Robert Scalia enrolled in Medicare?

Yes. Robert Scalia 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.

What insurance does Robert Scalia accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Robert Scalia 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.

Is Robert Scalia affiliated with any hospitals?

According to CMS data, Robert Scalia is affiliated with Schuylkill Medical Center - South Jackson Street, Wellspan Good Samaritan Hospital and Geisinger St. Luke's Hospital.

When was this NPI record last updated?

The NPPES record for Robert Scalia was last updated on January 30, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years 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.