Dr Karen Ann Ephlin, MD - Medicare Pediatrics in Wilkes Barre, PA

Dr Karen Ann Ephlin, MD is a medicare enrolled "Pediatrics" physician in Wilkes Barre, Pennsylvania. Her current practice location is 166 Hanover St, Wilkes Barre, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at (570) 808-6672.

Dr Karen Ann Ephlin is licensed to practice in Pennsylvania (license number MD426154) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1114992344.

Contact Information

Dr Karen Ann Ephlin, MD
166 Hanover St,
Wilkes Barre, PA 18702-3549
(570) 808-6672
(570) 808-6673

Map and Direction




Physician's Profile

Full NameDr Karen Ann Ephlin
GenderFemale
SpecialityPediatrics
Location166 Hanover St, Wilkes Barre, Pennsylvania
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1114992344
  • Provider Enumeration Date: 02/21/2006
  • Last Update Date: 08/10/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 3274579149
  • Enrollment ID: I20050630000397

Medical Identifiers

Medical identifiers for Dr Karen Ann Ephlin such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1114992344NPI-NPPES
198834OtherPAMEDICARE
02682057MedicaidNY
GU039851OtherPAMEDICARE GROUP

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics 236228-1 (New York)Secondary
208000000XPediatrics MD426154 (Pennsylvania)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Karen Ann Ephlin allows following entities to bill medicare on her behalf.
Entity NameGeisinger Clinic
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1366493868
PECOS PAC ID: 5395657001
Enrollment ID: O20040130000518

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Karen Ann Ephlin is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Karen Ann Ephlin, MD
100 N Academy Ave,
Danville, PA 17822-4903

Ph: (570) 271-6144
Dr Karen Ann Ephlin, MD
166 Hanover St,
Wilkes Barre, PA 18702-3549

Ph: (570) 808-6672

Reviews and Comments


Pediatrics Doctors in Wilkes Barre, PA

Dr. Jasmine Vincent, M.D.
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Medicare: Medicare Enrolled
Practice Location: 25 Church St, Wilkes Barre, PA 18765
Phone: 570-808-3181    
Dr. Akila Venkataraman, MD
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Medicare: Medicare Enrolled
Practice Location: 1000 E Mountain Blvd, Wilkes Barre, PA 18711
Phone: 570-808-7300    
Mr. Leopoldo Poblete Legaspi Jr., MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 25 Church St, Wilkes Barre, PA 18702
Phone: 570-808-3100    
Dr. Jayesh B Shah, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 1000 E Mountain Blvd, Wilkes Barre, PA 18711
Phone: 570-808-8653    Fax: 570-808-8658
Dr. Michelle K Sudo, DO
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 1102 Highway 315 Blvd, Wilkes Barre, PA 18702
Phone: 570-235-1470    Fax: 570-550-9356
Dr. Catherine C Muhumuza, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 1000 E Mountain Blvd, Wilkes Barre, PA 18711
Phone: 570-808-8653    Fax: 570-808-8658

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.