NPIMap

Paul G Avadanian, DO

Individual provider Active NPI Family Medicine Physician · Ephrata, PA

NPI 1043313083 · NPPES record last updated Jun 10, 2024

Key facts

NPI
1043313083
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
OS008957L (PA)
Practice address
136 A&B Lake Street
Lake Street Family Practice
Ephrata, PA 17522
Phone
(717) 721-7718
Fax
(717) 721-7726
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 16

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 15

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

Medicare Care Compare profile

Specialty
General Practice
Education
Nova Southeastern College of Osteo Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellspan Medical Group (2,438 clinicians)

Practice addresses (Care Compare)

136 Lake St
Ephrata, PA 17522-2415
Phone (717) 721-7718

Hospital & facility affiliations

  • Wellspan Vna Home Care Home health agency · York, PA · CCN 397004
  • Wellspan Ephrata Community Hospital Hospital · Ephrata, PA · CCN 390225
  • Wellspan Good Samaritan Hospital Hospital · Lebanon, PA · CCN 390066
  • Lancaster General Hospital Hospital · Lancaster, PA · CCN 390100
  • Wellspan York Hospital Hospital · York, PA · CCN 390046

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20040810000327 PA Practitioner - General Practice 4082686191 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group Current
since May 5, 2017		 Accepting new patients
Ephrata Community Hospital Current
since May 18, 2009		 Accepting new patients
Wellspan Medical Group Family Medicine Current
since May 5, 2017		 Accepting new patients
Ephrata Community Hospital Current
since May 18, 2009		 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group Family Medicine Past Accepting new patients
Chiropractic Head&Neck Treatment Center Past
since Jul 9, 2014		 Accepting new patients
Ephrata Community Hospital Past Accepting new patients

Locations

9 Nathan Ln
Annville, PA 17003
Phone (717) 639-3350

770 Broad St
East Earl, PA 17519
Phone (717) 445-4576

808 Pleasantview Dr
Ephrata, PA 17522
Phone (717) 733-6518

4131A Oregon Pike
Ephrata, PA 17522
Phone (717) 859-1123

136E Lake St
Ephrata, PA 17522
Phone (717) 721-7718

175 Martin Ave
Ste 125
Ephrata, PA 17522
Phone (717) 812-4602

446 N Reading Rd
Ephrata, PA 17522
Phone (717) 738-4334

169 Martin Ave
Ephrata, PA 17522
Phone (717) 733-0311

264 Granite Run Dr
Lancaster, PA 17601
Phone (717) 721-8205

368 W Main St
Leola, PA 17540
Phone (717) 656-6122

101 W Airport Rd
Lititz, PA 17543
Phone (717) 466-2445

427 W Main St
Ste I
New Holland, PA 17557
Phone (717) 355-5575

435 S Kinzer Ave
New Holland, PA 17557
Phone (717) 351-2419

30 W Swartzville Rd
Reinholds, PA 17569
Phone (717) 466-5420

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

1600 S George St
York, PA 17403
Phone (717) 848-3615

2250 E Market St
York, PA 17402
Phone (717) 812-6670

Interoperability endpoints

  • Direct secure messaging: pavadanian@direct-address.net
  • Direct secure messaging: pavadanian38926@wellspan.direct-ci.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS008957L PA Yes

Addresses

Primary practice location

136 A&B Lake Street
Lake Street Family Practice
Ephrata, PA 17522

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 851-1405

Other practice location 1

9 Nathan Ln
Annville, PA 17003-6500
Phone (717) 639-3350

Other practice location 2

808 Pleasantview Dr
Ephrata, PA 17522-1644
Phone (717) 733-9090

Other practice location 3

770 Broad St
East Earl, PA 17519-9752
Phone (717) 445-4576

Other practice location 4

435 S Kinzer Ave
New Holland, PA 17557-8706
Phone (717) 351-2419

Other practice location 5

368 W Main St
Leola, PA 17540-1761
Phone (717) 656-6122

Other practice location 6

2320 Rothsville Rd
Lititz, PA 17543-8215
Phone (717) 721-4800

Other practice location 7

4131A Oregon Pike
Ephrata, PA 17522-9550
Phone (717) 859-1123

Other practice location 8

2250 E Market St
York, PA 17402-2857
Phone (717) 851-1566

Other practice location 9

30 W Swartzville Rd
Reinholds, PA 17569-9641
Phone (717) 484-4347

Other practice location 10

264 Granite Run Dr
Lancaster, PA 17601-6804
Phone (717) 721-8205

Other practice location 11

96 Sofia Dr
Shrewsbury, PA 17361-5201
Phone (717) 812-2400

Other practice location 12

446 N Reading Rd
Ephrata, PA 17522-9802
Phone (717) 721-7718

Other practice location 13

455 S Washington St
Gettysburg, PA 17325-2516
Phone (717) 339-2875

Other practice location 14

101 W Airport Rd
Lititz, PA 17543-9274
Phone (717) 466-2445

Other identifiers

IdentifierTypeStateIssuer
500488OtherPAUSH/HMO
P002390OtherPAGATEWAY
500048OtherPAAETNA
50051223OtherPACAPITAL BLUE
0015922740004MedicaidPA
858854OtherPABLUE SHIELD
P00255543OtherPARAILROAD MEDICARE

Other providers in Ephrata, PA

All providers in Ephrata, PA · Family Medicine Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.