DR. MICHAEL J. FOX M.D.
NPI 1235106238
Internal Medicine in Wilkes Barre, PA

Q: What is Michael Fox's NPI number?

The NPI number for Michael Fox is 1235106238. It was assigned to this individual provider in the NPPES registry on March 8, 2006.

Q: What is Michael Fox'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 Michael Fox was last updated on May 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since March 08, 2006PECOS Enrolled

1000 E MOUNTAIN BLVD, WILKES BARRE, PA 18711(570) 808-6444(570) 808-5040 Get Directions Write a Review

NPPES record last updated: May 2, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 2, 2022, Aug 12, 2020 (2 updates tracked since 2020).

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About Dr. Michael J. Fox M.d. NPPES

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

DR. MICHAEL J. FOX M.D. (NPI 1235106238) is an individual internal medicine provider in Wilkes Barre, Pennsylvania, licensed in Pennsylvania (MD043021L) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1235106238

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. MICHAEL J. FOXCredential: M.D.

Location Address1000 E MOUNTAIN BLVDWilkes Barre, PA 18711-0027

Mailing Address660 Baltimore DrWilkes Barre, PA 18702-7962 · (570) 271-6144 · Fax (570) 271-6578

Phone(570) 808-6444

Fax(570) 808-5040

Sole ProprietorNo

Enumeration DateMarch 8, 2006

Last NPPES UpdateMay 2, 20222 updates tracked since enumeration

NPPES CertifiedMay 2, 2022

✔ NPI 1235106238 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 · MD043021L

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.

1000 E MOUNTAIN BLVD, Wilkes Barre, PA 18711

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Other Identifiers 1

Medicaid001246097PA

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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Michael J. Fox M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Michael Fox reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Geisinger Clinic

0.3 mi

Optometrist

1000 E MOUNTAIN DR
Wilkes Barre, PA 18711

Reassigned Medicare billing, Pennsylvania enrollment
4,429 clinicians in this Medicare group

NPI 1366492902 (570) 826-7300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

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 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.

525 services265 patients

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.

117 services97 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.

12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18711 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.

Referred Medical Equipment & Supplies CMS DME claims 17

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 suppliers41 claims98 services$5.55 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

6 suppliers16 claims16 services$1.01 avg. paid by Medicare

For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe A5500

DME-Orthotic Devices · category DF000N

5 suppliers15 claims30 services$61.41 avg. paid by Medicare

For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each A5512

DME-Orthotic Devices · category DF000N

4 suppliers14 claims84 services$25.06 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

7 suppliers18 claims18 services$42.55 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

7 suppliers17 claims17 services$11.72 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 20

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

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