Basic Information
| Provider Information | |||||||||
| NPI: | 1528029006 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TRICARICO | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | ANDREW | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 457 NORTH MAIN ST | ||||||||
| Address2: | STE 105 | ||||||||
| City: | PITTSTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 186402185 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5708839444 | ||||||||
| FaxNumber: | 5708839333 | ||||||||
| Practice Location | |||||||||
| Address1: | 499 WYOMING AVE STE 105 | ||||||||
| Address2: | |||||||||
| City: | KINGSTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 187043602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5707143050 | ||||||||
| FaxNumber: | 5707143055 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2006 | ||||||||
| LastUpdateDate: | 08/12/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/12/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OS010594L | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 002573 | 01 | PA | UNITED HEALTHCARE | OTHER | 60253 E180 | 01 | PA | GEISINGER HEALTH | OTHER | 001863297001 | 05 | PA | MEDICAID | 1307341 | 01 | PA | FIRST PRIORITY LIFE | OTHER | 002627 | 01 | PA | FIRST PRIORITY HEALTH | OTHER | 60253 E180 | 01 | PA | GEISINGER GOLD | OTHER | 002627 | 01 | PA | FIRST PRIORITY HEALTH CAP | OTHER | 080176555 | 01 | PA | RAILROAD MEDICARE | OTHER | 60253 | 01 | PA | GEISINGER CAPITATION | OTHER | 002573 | 01 | PA | AETNA | OTHER | 047917 | 01 | PA | MEDICARE-MLRM | OTHER | 1307341 | 01 | PA | PA BLUE SHIELD | OTHER | 010122600 | 01 | PA | FEDERAL BLACK LUNG | OTHER | 2000683000 | 01 | PA | PA BS PERSONAL CHOICE | OTHER | 249865 | 01 | PA | PHS | OTHER |