NPIMap

Individual provider Active NPI

Isabela Marlene Tetino, PA-C

  • Physician Assistant
  • Danville, PA
National Provider Identifier
1033754510
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA061205 Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-6058
Phone
(570) 271-6367
Fax
(570) 271-7142
NPI assigned
Nov 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X MA061205 PA
Physician Assistant 363A00000X MA061205 PA Primary

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-6058

Mailing address

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

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
I20200127002315 PA Practitioner - Physician Assistant 7911332671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

21 Geisinger LN
Lewistown, PA 17044-3400
Phone (717) 242-4200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA061205PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Jul 18, 2022 Accepting new patients
Geisinger Clinic CurrentSince Jul 18, 2022 Accepting new patients
Dubois Regional Medical Center Physician Assistant Past Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300

Interoperability endpoints

  • Direct secure messaging: itetino500309@direct.geisinger.edu

Organizations & group practices 5

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 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1573171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1033754510",
    "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": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178226058",
            "telephone_number": "570-271-6367",
            "fax_number": "570-271-7142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETINO",
        "first_name": "ISABELA",
        "middle_name": "MARLENE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-08",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "PA",
            "license": "MA061205",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA061205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.