NPI Information

  • NPI: 1063607893
  • Provider Name: LACKAWANNA MOBILE X-RAY, INC.
  • Classification: Portable X-ray and/or Other Portable Diagnostic Imaging Supplier - 335V00000X
  • Entity Type: Organization
  • Address: 1229 MONROE AVE
    DUNMORE, PA
    ZIP 18509
  • Phone: (800) 789-7082

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NPI Details

LACKAWANNA MOBILE X-RAY, INC. is a portable x ray and or other portable diagnostic imaging supplier in Dunmore, PA. The provider is a supplier that provides one or more of the following portable services, including but not limited to, x-ray, electrocardiogram (EKG), long-term EKG (Holter Monitor), bone densitometry, sonography, and other imaging services in accordance with all state and federal requirements, under the general supervision of a qualified physician. All necessary resources are transported to the patient's location where the services are performed. LACKAWANNA MOBILE X-RAY, INC. NPI is 1063607893. The provider is registered as an organization entity type.

The provider's business location address is:

1229 MONROE AVE
DUNMORE, PA
ZIP 18509-807
Phone: (800) 789-7082
Fax: (800) 801-7684

The provider's authorized official is Paul Woelkers .
The authorized official title is President and has the following contact phone number (570) 346-5115.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Ultrasound study of one arm or leg veins with compression and maneuvers (HCPCS:93971)
  • Ultrasound study of arm or leg veins with compression and maneuvers (HCPCS:93970)
  • Complete ultrasound scan of abdomen (HCPCS:76700)
  • Ultrasound of heart with color-depicted blood flow, rate, direction and valve function (HCPCS:93306)
  • Ultrasound of leg arteries or artery grafts (HCPCS:93925)
  • Limited ultrasound scan behind abdominal cavity (HCPCS:76775)
  • Complete ultrasound scan behind abdominal cavity (HCPCS:76770)
  • Ultrasound scan of head and neck soft tissue (HCPCS:76536)
  • Ultrasound of one leg arteries or artery grafts (HCPCS:93926)
  • Limited ultrasound scan of abdomen (HCPCS:76705)
  • Ultrasound of both sides of head and neck blood flow (HCPCS:93880)
  • Complete ultrasound scan of pelvis (HCPCS:76856)
  • Screening mammography (HCPCS:77067)
  • Electrocardiogram (ecg) 2-day continuous with review and report by health care professional (HCPCS:93224)
  • Limited ultrasound scan of joint or other extremity structure lacking blood vessels (HCPCS:76882)
  • Limited ultrasound scan of pelvis (HCPCS:76857)
  • Ultrasound scan of scrotum (HCPCS:76870)
  • Complete ultrasound scan of 1 breast (HCPCS:76641)
  • Complete ultrasound scan of joint (HCPCS:76881)
  • Limited ultrasound scan of 1 breast (HCPCS:76642)

The enumeration date for this NPI number is 9/14/2007 and was last updated on 5/9/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1335V00000XPortable X-ray and/or Other Portable Diagnostic Imaging SupplierPENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12771012000OTHERPENNSYLVANIAPERSONAL CHOICE
22771012000OTHERPENNSYLVANIAKEYSTONE 65
32771012000OTHERPENNSYLVANIABLUE CHOICE
40010364100002MEDICAIDPENNSYLVANIA
5111035MEDICARE PINPENNSYLVANIA
62771012000OTHERPENNSYLVANIAAMERIHEALTH
70526476OTHERPENNSYLVANIAAETNA
850002829OTHERPENNSYLVANIACAPITAL BLUE CROSS
9300004695OTHERPENNSYLVANIAPALMETTO MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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