1. Home
  2. Directory
  3. Pennsylvania
  4. Tobyhanna
  5. Internal Medicine
  6. NPI Profile

MARIA L. SHIPTOSKI D.O.
NPI 1497116826
Internal Medicine in Tobyhanna, PA

Active since March 12, 2016PECOS EnrolledAccepts Medicare Assignment
79.45/100
CMS Quality Rating
100 COMMUNITY DR, TOBYHANNA, PA 18466(570) 839-8754(570) 839-0893 Get Directions Write a Review

NPPES record last updated: November 4, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 4, 2021, Aug 12, 2019 (2 updates tracked since 2019).

About Maria L. Shiptoski D.o. NPPES

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

MARIA L. SHIPTOSKI D.O. (NPI 1497116826) is an individual internal medicine provider in Tobyhanna, Pennsylvania, licensed in Pennsylvania (OS019845) and active in the NPI registry since March 2016. She is enrolled in Medicare PECOS, is affiliated with Lehigh Valley Hospital, and is a graduate of Philadelphia College Of Osteopathic Medicine (2016).

NPPES Registry Identity

NPI1497116826
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameMARIA L. SHIPTOSKICredential: D.O.
Location Address100 COMMUNITY DRTobyhanna, PA 18466-8985
Mailing Address2100 Mack Blvd Fl 4Allentown, PA 18103-5622 · (484) 629-2282
Phone(570) 839-8754
Fax(570) 839-0893
Sole ProprietorNo
Medical School CMSPhiladelphia College Of Osteopathic MedicineGraduated 2016
Enumeration DateMarch 12, 2016
Last NPPES UpdateNovember 4, 20212 updates tracked since enumeration
NPPES CertifiedNovember 4, 2021
✔ NPI 1497116826 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 · OS019845
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.

100 COMMUNITY DR, Tobyhanna, PA 18466
Open in Google Maps ↗

Other Identifiers 1

OtherOS019845PA · State License

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

Maria L. Shiptoski 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 ID1254616626
PECOS Enrollment IDI20190725000028
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 6

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.
210 services110 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.
58 services58 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.
15 services14 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
14 services14 patients
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438
An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.
14 services14 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
13 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Lehigh Valley Hospital

Acute Care Hospitals · Allentown, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390133
Location1200 South Cedar Crest BoulevardAllentown, PA 18103 · Lehigh County
Emergency services Birthing friendly

Lehigh Valley Hospital - Pocono

Acute Care Hospitals · East Stroudsburg, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390201
Location206 East Brown StreetEast Stroudsburg, PA 18301 · Monroe County
Emergency services Birthing friendly

St Luke's Hospital - Monroe Campus

Acute Care Hospitals · Stroudsburg, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390330
Location100 St Luke's LaneStroudsburg, PA 18360 · Monroe County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18466 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.

79.45/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality80.12
Promoting Interoperability86
Improvement Activities40
Cost60.65

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.

HEALTH POCONOS, INC
Clinic/Center (Rehabilitation)
100 COMMUNITY DR, 105
TOBYHANNA, PA 18466
Monroe County (570) 839-9975
PATRICIA C ORWIG LPT
Physical Therapist
100 COMMUNITY DR, 105
TOBYHANNA, PA 18466
Monroe County (570) 839-9975
HEATH JONES MOTRL
Occupational Therapist
100 COMMUNITY DR, SUITE 105
TOBYHANNA, PA 18466
Monroe County (570) 839-9972
KAREN POWELL CRNP
Nurse Practitioner (Obstetrics & Gynecology)
100 COMMUNITY DR, POCONO OBSTETRICS AND GYNECOLOGY. SUITE 205
TOBYHANNA, PA 18466
Monroe County (570) 895-4331
SHARON A. BOLSAR PA-C
Physician Assistant (Medical)
100 COMMUNITY DR, MOUNTAIN FAMILY CARE. SUITE 102
TOBYHANNA, PA 18466
Monroe County (570) 895-2300
MARC M. KEULER MD
Internal Medicine
100 COMMUNITY DR, PMC PHYSICIAN ASSOC .- INTERNAL MEDICINE. SUITE 203
TOBYHANNA, PA 18466
Monroe County (570) 839-8754
MICHAEL TURSO MS,CCC SLP
Speech-Language Pathologist
100 COMMUNITY DR, SUITE 105
TOBYHANNA, PA 18466
Monroe County (570) 839-9975
JAMES T KINCEL JR. PA-C
Physician Assistant
100 COMMUNITY DR, SUITE 203
TOBYHANNA, PA 18466
Monroe County (570) 839-8754

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 Maria Shiptoski's NPI number?

The NPI number for Maria Shiptoski is 1497116826. It was assigned to this individual provider in the NPPES registry on March 12, 2016.

Where is Maria Shiptoski located?

Maria Shiptoski practices at 100 Community Dr, Tobyhanna, PA 18466. The listed phone number is (570) 839-8754.

What is Maria Shiptoski's specialty?

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

Is Maria Shiptoski enrolled in Medicare?

Yes. Maria Shiptoski 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 Maria Shiptoski accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Maria Shiptoski 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 Maria Shiptoski affiliated with any hospitals?

According to CMS data, Maria Shiptoski is affiliated with Lehigh Valley Hospital, Lehigh Valley Hospital - Pocono and St Luke's Hospital - Monroe Campus.

When was this NPI record last updated?

The NPPES record for Maria Shiptoski was last updated on November 4, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.