NORTHEASTERN SURGICAL SPECIALTY GROUP INC
NPI 1457381113
Surgery in Forty Fort, PA

NPI Status: Active since July 05, 2006

Contact Information

190 WELLES ST
FORTY FORT, PA
ZIP 18704
Phone: (570) 283-2323
Fax: (570) 283-1290

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  • Organization
  • Surgery
  • CLIA Number: 39D2095438
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 05-06-2027

About NORTHEASTERN SURGICAL SPECIALTY GROUP INC

This page provides the complete NPI Profile along with additional information for Northeastern Surgical Specialty Group Inc, a provider established in Forty Fort, Pennsylvania operating as a Surgery. The healthcare provider is registered in the NPI registry with number 1457381113 assigned on July 2006. The practitioner's primary taxonomy code is 208600000X. The provider is registered as an organization and their NPI record was last updated 14 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dan F Kopen Md (President)

NPI
1457381113
Provider Name
NORTHEASTERN SURGICAL SPECIALTY GROUP INC
Entity Type
Organization
Location Address
190 WELLES ST FORTY FORT, PA 18704
Location Phone
(570) 283-2323
Location Fax
(570) 283-1290
Mailing Address
190 WELLES ST FORTY FORT, PA 18704
Mailing Phone
(570) 283-2323
Mailing Fax
(570) 283-1290
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-05-2006
Last Update Date
11-01-2012
Code Navigator

A surgeon like Northeastern Surgical Specialty Group Inc treats injuries, diseases, and deformities through surgical operations. A surgeon could correct physical deformities, repair bone and tissue, or perform preventive or elective surgeries. Surgeons also examine patients, perform and interpret diagnostic tests, and provide counsel on preventive healthcare.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Surgery

Taxonomy Code
208600000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DAN F KOPEN MD

Authorized Official Title
PRESIDENT
Authorized Official Phone
(570) 283-2323

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
190358OTHER (01)PAHIGHMARK BLUE SHIELD
88381OTHER (01)PAUNITED HEALTHCARE
B34409OTHER (01)PASTERLING
072571OTHER (01)PAFIRST PRIORITY
0010907280003MEDICAID (05)PA 
7227OTHER (01)PAGEISINGER HEALTH PLAN
CL6001MEDICARE PIN (08)PA 
25126OTHER (01)PAHEALTH AMERICA
876894OTHER (01)PACOVENTRY
61472OTHER (01)PAAETNA US HEALTHCARE
190358MEDICARE PIN (08)PA 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
39D2095438
Facility Type
Physician Office
Certificate Effective Date
May 07, 2025
Certificate Expiration Date
May 06, 2027
Laboratory Director
DR. THOMAS S. BOLAND
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Northeastern Surgical Specialty Group Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for NORTHEASTERN SURGICAL SPECIALTY GROUP INC

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1457381113, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
7
Unchanged
Pos 5
3
Doubled → 6
Pos 6
8
Unchanged
Pos 7
1
Doubled → 2
Pos 8
1
Unchanged
Pos 9
1
Doubled → 2
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 3 → 6 1 → 2 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 1 + 0 + 7 + 6 + 8 + 2 + 1 + 2 + 24 = 57

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1457381113.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Dentist (Orthodontics and Dentofacial Orthopedics)
190 WELLES ST
FORTY FORT, PA 18704
Clinic/Center (Radiology)
190 WELLES ST
FORTY FORT, PA 18704
Audiologist-Hearing Aid Fitter
190 WELLES ST
FORTY FORT, PA 18704
Physical Therapist
190 WELLES ST, SUITE 166
FORTY FORT, PA 18704
Physical Therapist
190 WELLES ST, SUITE 166
FORTY FORT, PA 18704
Radiology (Diagnostic Radiology)
190 WELLES ST
FORTY FORT, PA 18704
Surgery
190 WELLES ST
FORTY FORT, PA 18704
Specialist
190 WELLES ST
FORTY FORT, PA 18704
Physical Therapist
190 WELLES ST
FORTY FORT, PA 18704
Specialist
190 WELLES ST
FORTY FORT, PA 18704
Physical Therapist
190 WELLES ST
FORTY FORT, PA 18704
Specialist
190 WELLES ST
FORTY FORT, PA 18704
Physical Therapist
190 WELLES ST, SUITE 166
FORTY FORT, PA 18704
Speech-Language Pathologist
190 WELLES ST
FORTY FORT, PA 18704
Dietitian, Registered
190 WELLES ST, SUITE 166
FORTY FORT, PA 18704
Radiology (Diagnostic Radiology)
190 WELLES ST
FORTY FORT, PA 18704
Radiology (Radiation Oncology)
190 WELLES ST
FORTY FORT, PA 18704
Nurse Anesthetist, Certified Registered
190 WELLES ST
FORTY FORT, PA 18704
Pediatrics
190 WELLES ST, STE 122
FORTY FORT, PA 18704
Psychiatry & Neurology (Neurology)
190 WELLES ST, STE 114
FORTY FORT, PA 18704

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1457381113, enumerated as an "organization" on July 05, 2006.

The provider is located at 190 WELLES ST FORTY FORT, PA 18704 and the phone number is (570) 283-2323.

Surgery with taxonomy code 208600000X.

The provider might be accepting Accepts: Blue Cross Blue Shield, Highmark Blue Shield,. Please consult your insurance carrier or call the provider to verify.