Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Cleanslate Medical Group of Pennsylvania LLC

Organization Addiction Medicine (Internal Medicine) Physician · NPI 1184177263

Cleanslate Medical Group of Pennsylvania LLC is an Addiction Medicine (Internal Medicine) Physician in Wilkes Barre, Pennsylvania. Registered with an NPI since 2016.

In the registry since
2016
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

100 N Wilkes Barre Blvd Ste 103
Wilkes Barre, PA 18702-5240
Phone: (413) 584-2173
Fax: (833) 279-7074
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Multi-Specialty Clinic/Center (primary) Taxonomy 261QM1300X
Addiction Medicine (Internal Medicine) Physician Taxonomy 207RA0401X

Record details

NPI number1184177263
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Matthew Smolarek — Cfo · (412) 999-5188
NPI enumeratedJuly 26, 2016
Last updated in NPPESDecember 17, 2025
Certification dateDecember 17, 2025
Mailing address8 Cadillac Dr Ste 300, Brentwood, TN 37027-5337