Individual provider Active NPI

Lindsay L Shalata, PA-C

  • Physician Assistant
  • Dallas, PA
National Provider Identifier
1023343076
Registry record updated Aug 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA054085 Issued in PA
Practice address
16 Church St
Dallas, PA 18612-1136
Phone
(570) 675-2111
Fax
(570) 675-6545
NPI assigned
Oct 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OA002397 PA
Physician Assistant 363A00000X MA054085 PA Primary

Addresses

Primary practice location

16 Church St
Dallas, PA 18612-1136

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other names 1

  • Lindsay L Raurk Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lshalata98074@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091116000516 PA Practitioner - Physician Assistant 4981742764 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Jan 13, 2020 Accepting new patients
Geisinger Clinic CurrentSince Jan 13, 2020 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

16 Church St
Dallas, PA 18612
Phone (570) 675-2111

114 Lt Michael Cleary Dr
Dallas, PA 18612
Phone (570) 255-1178

100 N Academy Ave
Danville, PA 17822

126 Market Way
Mount Pocono, PA 18344
Phone (570) 839-3633

531 Mt Pleasant Dr
Scranton, PA 18503
Phone (570) 342-8500

50 Roosevelt Ter
Wilkes Barre, PA 18702
Phone (570) 808-8780

Interoperability endpoints

  • Direct secure messaging: lshalata98074@direct.geisinger.edu

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1254960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1023343076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 CHURCH ST",
            "city": "DALLAS",
            "state": "PA",
            "postal_code": "186121136",
            "telephone_number": "570-675-2111",
            "fax_number": "570-675-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHALATA",
        "first_name": "LINDSAY",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-08",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA002397",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA054085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lshalata98074@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "16 Church St",
            "city": "Dallas",
            "state": "PA",
            "country_code": "US",
            "postal_code": "186121136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LINDSAY",
            "last_name": "RAURK",
            "middle_name": "L",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, PA

Sources for this page

Verify at the official NPI Registry.