Kyle Landis (NPI# 1144773151, PAC ID# 2769778646) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1144773151 |
| PAC ID by PECOS | 2769778646 |
| Professional Enrollment ID | I20160831002376 |
| Full Name | Kyle Landis |
| Organization Legal Name | COMMONWEALTH PHYSICIAN NETWORK LLC |
| Address |
4 E Main St Nanticoke PA 18634-1602 |
| Phone Number | 5707357474 |
| Gender | M |
| Graduation Year | 2016 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 2668696592 |
| Number of Group Practice Members | 45 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 390137 | WILKES-BARRE GENERAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 4 E Main St, Nanticoke, PA 18634-1602 | 5707357474 | COMMONWEALTH PHYSICIAN NETWORK LLC |
| 200 S River St, Plains, PA 18705-1143 | 5708211100 | COMMONWEALTH PHYSICIAN NETWORK LLC |
| 575 N River St, Wilkes Barre, PA 18702-2634 | 5705528938 | COMMONWEALTH PHYSICIAN NETWORK LLC |
| Organization Legal Name | COMMONWEALTH PHYSICIAN NETWORK LLC |
| Physicians | 44 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Philip V Savia | Neurology | Commonwealth Physician Network LLC | 670 N River St, Suite 203, Plains, PA 18705-1028 |
| James M Mattucci Jr. | Orthopedic Surgery | Commonwealth Physician Network LLC | 118 E 3rd St, Berwick, PA 18603-3720 |
| Gary Neale | General Surgery | Commonwealth Physician Network LLC | 720 Madison Ave, Scranton, PA 18510-1609 |
| Marci A Kowalewski | Physician Assistant | Commonwealth Physician Network LLC | 263 Carbondale Rd, Waymart, PA 18472-9113 |
| Juan Jose Derojas | Vascular Surgery | Commonwealth Physician Network LLC | 4 E Main St, Nanticoke, PA 18634-1602 |
| Helen Shorten Trygar | Nurse Practitioner | Commonwealth Physician Network LLC | 10 Dundaff St, Carbondale, PA 18407-1869 |
| Angela Marie Stewart | Nurse Practitioner | Commonwealth Physician Network LLC | 4 E Main St, Nanticoke, PA 18634-1602 |
| Alexa Lee Beretski | Physician Assistant | Commonwealth Physician Network LLC | 4 E Main St, Nanticoke, PA 18634-1602 |
| Chester Charles Yavorski | Vascular Surgery | Commonwealth Physician Network LLC | 4 E Main St, Nanticoke, PA 18634-1602 |
| Sean V Obrien | Physician Assistant | Commonwealth Physician Network LLC | 4 E Main St, Nanticoke, PA 18634-1602 |
| Street Address |
4 E MAIN ST |
| City | NANTICOKE |
| State | PA |
| Zip | 18634-1602 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Juan Jose Derojas | Vascular Surgery | Commonwealth Physician Network LLC | 4 E Main St, Nanticoke, PA 18634-1602 |
| Angela Marie Stewart | Nurse Practitioner | Commonwealth Physician Network LLC | 4 E Main St, Nanticoke, PA 18634-1602 |
| Matthew N Kozicki | Family Medicine | Intermountain Medical Group Inc | 4 E Main St, Nanticoke, PA 18634-1602 |
| Alexa Lee Beretski | Physician Assistant | Commonwealth Physician Network LLC | 4 E Main St, Nanticoke, PA 18634-1602 |
| Chester Charles Yavorski | Vascular Surgery | Commonwealth Physician Network LLC | 4 E Main St, Nanticoke, PA 18634-1602 |
| Sean V Obrien | Physician Assistant | Commonwealth Physician Network LLC | 4 E Main St, Nanticoke, PA 18634-1602 |
| William P Charlton | Orthopedic Surgery | Commonwealth Physician Network LLC | 4 E Main St, Nanticoke, PA 18634-1602 |
| James Noto | Neurology | Commonwealth Physician Network LLC | 4 E Main St, Nanticoke, PA 18634-1602 |
| Clark Gerhart | General Surgery | Commonwealth Physician Network LLC | 4 E Main St, Nanticoke, PA 18634-1602 |
| Steven Marra | Thoracic Surgery | Commonwealth Physician Network LLC | 4 E Main St, Nanticoke, PA 18634-1602 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael A Havrilla | Optometry | Eye Care Specialists, P.C. | 9 N Market St, Nanticoke, PA 18634-1410 |
| Patricia Russo | Optometry | Eye Care Specialists, P.C. | 9 N Market St, Nanticoke, PA 18634-1410 |
| Andrew Eric Makos | Chiropractic | 445 W Main St, Nanticoke, PA 18634-1434 | |
| Gerald P Gibbons Jr. | Internal Medicine | Commonwealth Physician Network LLC | 4 E Main St, Nanticoke, PA 18634-1602 |
| Kalyani Meduri | Gastroenterology | Commonwealth Physician Network LLC | 4 E Main St, Nanticoke, PA 18634-1602 |
| Lauren Glowacki | Physician Assistant | Intermountain Medical Group Inc | 4 E Main St, Nanticoke, PA 18634-1602 |
| Michalene M Torbik | Family Medicine | Commonwealth Physician Network LLC | 4 E Main St, Nanticoke, PA 18634-1602 |
| Barry J Pernikoff | Colorectal Surgery (proctology) | Commonwealth Physician Network LLC | 4 E Main St, Nanticoke, PA 18634-1602 |
| Lynnae A Galella | Physician Assistant | Commonwealth Physician Network LLC | 4 E Main St, Nanticoke, PA 18634-1602 |
| Stephen Dule | Physician Assistant | Commonwealth Physician Network LLC | 4 E Main St, Nanticoke, PA 18634-1602 |
| Find all physicians in zip 18634 | |||
| City | NANTICOKE |
| Zip Code | 18634 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | NANTICOKE + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.