Michael Gerard Depalma, P.A.C.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

MA051333 Issued in PA

Practice address

2201 Brunswick Dr Ste 1200
Hanover, PA 17331-8350

Phone

(717) 637-0470

NPI assigned

Apr 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wellspan Medical Group

  • Pediatric Surgery Physician
  • York, PA
  • NPI 1104799428
  NPD (past)

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610755200000",
    "number": "1023071677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 BRUNSWICK DR STE 1200",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173318350",
            "telephone_number": "717-637-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 BRUNSWICK DR STE 1200",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173318350",
            "telephone_number": "717-637-0470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 Blooming Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Hanover",
            "state": "PA",
            "postal_code": "173317917",
            "country_code": "US",
            "telephone_number": "717-632-5259",
            "fax_number": "717-632-2422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEPALMA",
        "first_name": "MICHAEL",
        "middle_name": "GERARD",
        "name_prefix": "Mr.",
        "credential": "P.A.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2021-01-16",
        "certification_date": "2021-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA051333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD - FREEDOM BLUE",
            "identifier": "2696619",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY MEDICARE ASSURED",
            "identifier": "1587595",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdepalma87000@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "2201 Brunswick Dr Ste 1200",
            "city": "Hanover",
            "state": "PA",
            "country_code": "US",
            "postal_code": "173318350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Laura M Dean, RDN, LDN
• Cortlin Dell
• Kathryn M Demarre, MD
• Connie A Denney, P.A.-C
• Michael Richard Denney, DO
• Julie Lynn Derwart - Reh, CPM
• Alex Alan Despines, PA-C
• Patrick T Devine
• Rajiv Dhawan, MD
• Bibek Dhungana, MD

• Surgical Physician Assistant in Hanover, PA
• Providers in Hanover, PA by specialty
• Surgical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2021; 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.