Matthew N Kozicki (NPI# 1124330410, PAC ID# 0749415123) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1124330410 |
| PAC ID by PECOS | 0749415123 |
| Professional Enrollment ID | I20131022000289 |
| Full Name | Matthew N Kozicki |
| Organization Legal Name | INTERMOUNTAIN MEDICAL GROUP INC |
| Address |
4 E Main St Nanticoke PA 18634-1602 |
| Phone Number | 5702583939 |
| Gender | M |
| Graduation Year | 2010 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 7810894987 |
| Number of Group Practice Members | 73 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 390137 | WILKES-BARRE GENERAL HOSPITAL |
| 390270 | GEISINGER WYOMING VALLEY MEDICAL CENTER |
| 390001 | GEISINGER-COMMUNITY MEDICAL CENTER |
| 390201 | LEHIGH VALLEY HOSPITAL - POCONO |
| 390072 | BERWICK HOSPITAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 610 Wyoming Ave, Suite 2, Kingston, PA 18704-3702 | INTERMOUNTAIN MEDICAL GROUP INC | |
| 618 Wyoming Ave, Kingston, PA 18704-3702 | 5702839063 | INTERMOUNTAIN MEDICAL GROUP INC |
| 181 S Market St, Nanticoke, PA 18634-2305 | 5707356660 | INTERMOUNTAIN MEDICAL GROUP INC |
| 4 E Main St, Nanticoke, PA 18634-1602 | 5702583939 | INTERMOUNTAIN MEDICAL GROUP INC |
| 147 Amber Ln, Wilkes Barre, PA 18702-6545 | 5708241122 | INTERMOUNTAIN MEDICAL GROUP INC |
| Organization Legal Name | INTERMOUNTAIN MEDICAL GROUP INC |
| Physicians | 69 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel Rittenberg | Urology | Intermountain Medical Group Inc | 423 3rd Ave, Suite B, Kingston, PA 18704-5809 |
| Tarah Zajaczkowski | Physician Assistant | Intermountain Medical Group Inc | 16 Luzerne Ave, Suite 125, West Pittston, PA 18643-2817 |
| Kelly Sabaluski | Nurse Practitioner | Intermountain Medical Group Inc | 445 Wyoming Ave, Kingston, PA 18704-3601 |
| Kelly Babinski | Nurse Practitioner | Intermountain Medical Group Inc | 743 Jefferson Ave, Suite 203, Scranton, PA 18510-1638 |
| Kevin K Musto | Internal Medicine | Intermountain Medical Group Inc | 901 Wyoming Ave, West Pittston, PA 18643-2742 |
| Fred Usoh | Anesthesiology | Intermountain Medical Group Inc | 468 Northampton St, Kingston, PA 18704-4566 |
| Kimberly T Serine | Physician Assistant | Intermountain Medical Group Inc | 1099 S Township Blvd, Pittston, PA 18640-3247 |
| Noelle Altavilla | Registered Dietitian Or Nutrition Professional | Intermountain Medical Group Inc | 2 Poplar St, Kingston, PA 18704-3709 |
| Kamlesh R Patel | Internal Medicine | Intermountain Medical Group Inc | 500 Scott St, Wilkes Barre, PA 18702-5616 |
| Daniel J Dudrick | Family Medicine | Intermountain Medical Group Inc | 610 Wyoming Ave, Suite 2, Kingston, PA 18704-3702 |
| 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 |
| Kyle Landis | Physician Assistant | 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 |
| 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 | FAMILY MEDICINE |
| City + Specialty | NANTICOKE + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Matthew N Kozicki.
| 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.