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KANOUSE MEDICAL GROUP PC
NPI 1790859783
Internal Medicine in Berwick, PA

Active since November 20, 2006
695 E 16TH ST, SUITE D, BERWICK, PA 18603(570) 752-5500(570) 752-6790 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kanouse Medical Group Pc NPPES

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

KANOUSE MEDICAL GROUP PC (NPI 1790859783) is a healthcare organization registered as an internal medicine in Berwick, Pennsylvania and active in the NPI registry since November 2006. The organization lists Gary Douglas Kanouse, Physician, as its authorized official.

NPPES Registry Identity

NPI1790859783
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameKANOUSE MEDICAL GROUP PC
Location Address695 E 16TH ST, SUITE DBerwick, PA 18603-2320
Mailing Address695 E 16th St, Suite DBerwick, PA 18603-2320 · (570) 752-5500 · Fax (570) 752-6790
Phone(570) 752-5500
Fax(570) 752-6790
Organization SubpartNo
Authorized OfficialGary Douglas KanousePhysician · (570) 752-5500
Enumeration DateNovember 20, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1790859783 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 · MD-036479-E
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.
695 E 16TH ST, Berwick, PA 18603
Open in Google Maps ↗

Other Identifiers 2

Other50002681PA · Capital Blue Cross
Other1335094PA · Highmark Blue Shield

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kanouse Medical Group Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StatePennsylvaniaEnrollment IDO20040830000038Non-DME Part B · Clinic/Group PracticeDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Kanouse Medical Group PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Gary Kanouse, M.D.
Internal Medicine
NPI 1568521425
695 E 16TH ST SUITE D
Berwick, PA 18603
(570) 752-5500
✔ PECOSSame address

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

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 Kanouse Medical Group PC's NPI number?

The NPI number for Kanouse Medical Group PC is 1790859783. It was assigned to this organization in the NPPES registry on November 20, 2006.

Where is Kanouse Medical Group PC located?

Kanouse Medical Group PC is located at 695 E 16th St Suite D, Berwick, PA 18603. The listed phone number is (570) 752-5500.

What is Kanouse Medical Group PC's specialty?

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

Is Kanouse Medical Group PC enrolled in Medicare?

Yes. Kanouse Medical Group PC is registered in the Medicare PECOS enrollment system.

When is Kanouse Medical Group PC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Pennsylvania, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Kanouse Medical Group PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Kanouse Medical Group PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Kanouse Medical Group PC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.