Individual provider Active NPI

Pavlik Teleguz, CRNP

  • Family Nurse Practitioner
  • Ephrata, PA
National Provider Identifier
1033795026
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP023197 Issued in PA
Practice address
169 Martin Ave
Ephrata, PA 17522-1724
Phone
(717) 721-4740
Fax
(717) 738-6872
NPI assigned
Mar 22, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP023197 PA Primary

Addresses

Primary practice location

169 Martin Ave
Ephrata, PA 17522-1724

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 721-4740

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
I20210330000621 PA Practitioner - Nurse Practitioner 0446667935 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians
Tower Health Medical GroupGroup PAC ID 7618889213, 578 clinicians

Practice addresses (Care Compare)

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

400 Highland Ave
Lewistown, PA 17044-1167
Phone (717) 363-9071

420 S 5TH Ave
West Reading, PA 19611-2143
Phone (484) 628-8000

Hospital & facility affiliations

  • Geisinger-Lewistown Hospital Hospital, Lewistown, PA, CCN 390048

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Health Medical Group CurrentSince Sep 1, 2023 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Nov 14, 2022 Accepting new patients
Tower Health Medical Group CurrentSince Sep 1, 2023 Accepting new patients
Geisinger Clinic Sunbury CurrentSince Nov 14, 2022 Accepting new patients
Tower Health Medical Group Current Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

420 S 5th Ave
West Reading, PA 19611
Phone (484) 628-3637

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

Organizations & group practices 6

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 9

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

NPI Registry JSON

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1033795026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-721-4740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 MARTIN AVE",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221724",
            "telephone_number": "717-721-4740",
            "fax_number": "717-738-6872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELEGUZ",
        "first_name": "PAVLIK",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-22",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP023197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ephrata, PA

Sources for this page

Verify at the official NPI Registry.