SCRANTON CARDIOVASCULAR PHYSICIAN SERVICES LLC
NPI 1366725418
Internal Medicine - Cardiovascular Disease in Scranton, PA

Q: What is Scranton Cardiovascular Physician Services LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Active since September 26, 2011

743 JEFFERSON AVE STE 305, SCRANTON, PA 18510(570) 342-1776(570) 207-1910 Get Directions Write a Review

NPPES record last updated: January 26, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 26, 2022, Sep 21, 2021 (2 updates tracked since 2021).

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About Scranton Cardiovascular Physician Services Llc NPPES

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

SCRANTON CARDIOVASCULAR PHYSICIAN SERVICES LLC (NPI 1366725418) is a healthcare organization registered as a cardiovascular disease in Scranton, Pennsylvania and active in the NPI registry since September 2011. The organization lists Jennifer L Jackson, Senior Director Provider Enrollment, as its authorized official.

NPPES Registry Identity

NPI1366725418

Entity TypeOrganization

Primary Taxonomy207RC0000X

Legal Business NameSCRANTON CARDIOVASCULAR PHYSICIAN SERVICES LLC

Location Address743 JEFFERSON AVE STE 305Scranton, PA 18510-1639

Mailing Address4000 Meridian BlvdFranklin, TN 37067-6325 · (615) 465-7000 · Fax (615) 628-6877

Phone(570) 342-1776

Fax(570) 207-1910

Organization SubpartNo

Authorized OfficialJennifer L JacksonSenior Director Provider Enrollment · (877) 892-9815

Enumeration DateSeptember 26, 2011

Last NPPES UpdateJanuary 26, 20222 updates tracked since enumeration

NPPES CertifiedJanuary 26, 2022

✔ NPI 1366725418 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Also ListedNurse PractitionerTaxonomy 363L00000X

743 JEFFERSON AVE STE 305, Scranton, PA 18510

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Other Identifiers 2

Medicaid102687606-0001PA

Other237294Medicare

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

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 ›

Other Providers at the Same Location NPPES 5

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

DEEPIKA RAO KALISETTI M.D.

Internal Medicine (Interventional Cardiology)