PENNSYLVANIA ASSOCIATES LLC NPI 1447580584

NPI Information

  • NPI: 1447580584
  • Provider Name: PENNSYLVANIA ASSOCIATES, LLC
  • Classification: Clinic/Center - 261QM2800X
  • Specialization: Methadone
  • Entity Type: Organization
  • Doing Business As: MOUNT POCONO MEDICAL
  • CLIA Number: 39D2127333
  • Address: 663 MOUNT POCONO BLVD
    UNIT 3
    MOUNT POCONO, PA
    ZIP 18344
  • Phone: (570) 839-7246

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NPI Details

PENNSYLVANIA ASSOCIATES, LLC is a methadone clinic center in Mount Pocono, PA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. PENNSYLVANIA ASSOCIATES, LLC NPI is 1447580584. The provider is registered as an organization entity type.
The provider Is Doing Business As Mount Pocono Medical.

The provider's business location address is:

663 MOUNT POCONO BLVD
UNIT 3
MOUNT POCONO, PA
ZIP 18344
Phone: (570) 839-7246
Fax: (570) 839-7248

The provider's authorized official is Robyn Tanis .
The authorized official title is Executive Director Of Contract Mgmt and has the following contact phone number (856) 533-8762.

The CLIA number assigned to this NPI record is 39D2127333 - physician office with a certificate type of Certificate of Waiver.

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.

  • Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatm (HCPCS:G2067)

The enumeration date for this NPI number is 1/13/2010 and was last updated on 12/6/2019.

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
1261QM2800XClinic/CenterMethadone457036PENNSYLVANIAYes

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
1457036OTHERPENNSYLVANIAPA DEPARTMENT OF HEALTH LICENSE NUMBER

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

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