NPIMap

Individual provider Active NPI

Karissa Thal, MD

  • Family Medicine Physician
  • Bellefonte, PA
National Provider Identifier
1033679691
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD477151 Issued in PA
Practice address
141 Medical Park LN
Bellefonte, PA 16823-9112
Phone
(814) 355-7322
Fax
(814) 355-9604
NPI assigned
Mar 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD477151 PA Primary

Addresses

Primary practice location

141 Medical Park LN
Bellefonte, PA 16823-9112

Mailing address

141 Medical Park LN
Bellefonte, PA 16823-9112
Phone (814) 355-7322

Other practice location 1

500 University Dr
Hershey, PA 17033-2360
Phone (717) 531-8186

Other practice location 2

1850 E Park Ave Ste 207
State College, PA 16803-6706
Phone (814) 689-6789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220705003107 PA Practitioner - Family Practice 1052648771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Pennsylvania State University College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

141 Medical Park LN
Bellefonte, PA 16823-9112
Phone (814) 355-7322

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD477151PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Nittany Medical Center Health Services Inc Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
Mount Nittany Medical Center Health Services Inc Past Accepting new patients

Locations

141 Medical Park Ln
Bellefonte, PA 16823
Phone (814) 355-7322

2051 S Atherton St
State College, PA 16801
Phone (844) 278-4600

2121 Old Gatesburg Rd
Ste 100
State College, PA 16803
Phone (814) 231-6868

1850 E Park Ave
Ste 207
State College, PA 16803
Phone (814) 235-2480

164 Greenview Dr
State College, PA 16803
Phone (814) 237-4321

1700 Old Gatesburg Rd
Ste 310
State College, PA 16803
Phone (814) 237-3122

164 Greenview Dr
Ste 245
State College, PA 16803
Phone (814) 231-6868

155 Wellness Way
State College, PA 16803
Phone (800) 367-0179

1850 E Park Ave
Ste 201
State College, PA 16803
Phone (814) 234-8800

Organizations & group practices 2

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.

Hospital & facility affiliations 31

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1033679691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 MEDICAL PARK LN",
            "city": "BELLEFONTE",
            "state": "PA",
            "postal_code": "168239112",
            "telephone_number": "814-355-7322",
            "fax_number": "814-355-9604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 MEDICAL PARK LN",
            "city": "BELLEFONTE",
            "state": "PA",
            "postal_code": "168239112",
            "telephone_number": "814-355-7322",
            "fax_number": "814-355-9604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 University Dr",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "717-531-8186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1850 E Park Ave Ste 207",
            "address_purpose": "LOCATION",
            "city": "State College",
            "state": "PA",
            "postal_code": "168036706",
            "country_code": "US",
            "telephone_number": "814-689-6789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THAL",
        "first_name": "KARISSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD477151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellefonte, PA

Sources for this page

Verify at the official NPI Registry.