Susquehanna Physician Services

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

Legal business name

SUSQUEHANNA PHYSICIAN SERVICES

Practice address

1705 Warren Ave
Suite 201
Williamsport, PA 17701-2664

Phone

(570) 320-7645

Fax

(570) 320-7646

NPI assigned

May 31, 2007

Last updated

May 20, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Charles Santangelo

Title

Executive VP and Cfo

Phone

(570) 321-3171

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• SPS-Allergy & Immunology Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James G. Merrick, MD

  • Allergy & Immunology Physician
  • Saranac Lake, NY
  • NPI 1700890878
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274313600000",
    "number": "1013118389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "address_2": "PO BOX 3127",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177010127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 WARREN AVE",
            "address_2": "SUITE 201",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177012664",
            "telephone_number": "570-320-7645",
            "fax_number": "570-320-7646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSQUEHANNA PHYSICIAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2010-05-20",
        "status": "A",
        "authorized_official_last_name": "SANTANGELO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "EXECUTIVE VP AND CFO",
        "authorized_official_telephone_number": "570-321-3171",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1966309",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017300760193",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPS-Allergy & Immunology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lily Summers Trasiewicz, PA
• Susquehanna Cardiology Associates, P. C.
• Susquehanna Community Health and Dental Clinic, Inc.
• Susquehanna Health Pharmacy
• Susquehanna Imaging Associates, Inc.
• Susquehanna Physician Services (Susquehanna Health Medical Group)
• Susquehanna Physician Services (Susquehanna Health Medical Group)
• Susquehanna Physician Services (Susquehanna Health Medical Group)
• Susquehanna Physician Services
• Susquehanna Physician Services (Susquehanna Health Medical Group)

• Allergy & Immunology Physician in Williamsport, PA
• Providers in Williamsport, PA by specialty
• Allergy & Immunology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.