Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Tanner Rae Mazur, PA-C

Individual provider Physician Assistant · NPI 1124674270

Tanner Rae Mazur, PA-C is a Physician Assistant in Wilkes Barre, Pennsylvania. Qualified in 2019, 7 years ago. Practices with Geisinger Clinic, a 3,413-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
7
Licensed in
PA
In the registry since
2019
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1175 E Mountain Blvd
Wilkes Barre, PA 18702-7906
Phone: (570) 808-1095
Fax: (570) 808-7878
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 3 W Olive St, Scranton, PA 18508-2572 — (570) 961-3822
  • 3 W Olive St Ste 118, Scranton, PA 18508 — (570) 961-3823
  • 648 N Main St, Taylor, PA 18517-1112 — (570) 348-1101
  • 648 N Main St, Taylor, PA 18517-1112 — (570) 348-1101

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence MA060718 (PA)
Physician Assistant Taxonomy 363A00000X
Medical Physician Assistant Taxonomy 363AM0700X · Licence MA060718 (PA)

Record details

NPI number1124674270
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 14, 2019
Last updated in NPPESSeptember 27, 2022
Certification dateSeptember 27, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Geisinger Clinic — 3413 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

Other providers in Wilkes Barre