NPIMap

Individual provider Active NPI

Susan Berardinelli, PA-C

  • Physician Assistant
  • Portage, PA
National Provider Identifier
1043357577
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA002245L Issued in PA
Practice address
3670 Portage St
Portage, PA 15946-6546
Phone
(814) 736-9614
Fax
(814) 736-9783
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA002245L PA Primary

Addresses

Primary practice location

3670 Portage St
Portage, PA 15946-6546

Mailing address

1086 Franklin St
Johnstown, PA 15905-4305
Phone (814) 410-8300

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
I20070220000009 PA Practitioner - Physician Assistant 8224130489 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DLP Conemaugh Physician Practices LLC 286 clinicians
Legacy Healthcare Services Inc 3,431 clinicians

Practice addresses (Care Compare)

1111 Franklin St
Johnstown, PA 15905-4341

17470 Brookside Trace CT
Tampa, FL 33647-6201
Phone (813) 443-5042

3670 Portage St
Suite 105
Portage, PA 15946-6546
Phone (814) 736-9614

Hospital & facility affiliations

  • Conemaugh Memorial Medical Center Hospital, Johnstown, PA, CCN 390110
  • Chan Soon- Shiong Medical Center at Windber Hospital, Windber, PA, CCN 390112

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Conemaugh Physician Practices LLC CurrentSince Sep 1, 2014 Accepting new patients
DLP Conemaugh Memorial Medical Center LLC CurrentSince Oct 1, 2016 Accepting new patients
DLP Conemaugh Memorial Medical Center LLC CurrentSince Oct 1, 2016 Accepting new patients
DLP Conemaugh Physician Practices LLC Physician Assistant CurrentSince Sep 1, 2014 Accepting new patients
Conemaugh Health Initiatives Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

236 Jamesway Rd
Ebensburg, PA 15931
Phone (814) 471-6595

1020 Franklin St
Johnstown, PA 15905
Phone (814) 533-1095

1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

3670 Portage St
Portage, PA 15946
Phone (814) 736-9614

3670 Portage St
Ste 105
Portage, PA 15946
Phone (814) 736-3321

Interoperability endpoints

  • Direct secure messaging: sberardinelli9618@direct.conemaugh.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 2

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1043357577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 FRANKLIN ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054305",
            "telephone_number": "814-410-8300",
            "fax_number": "814-410-8331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3670 PORTAGE ST",
            "city": "PORTAGE",
            "state": "PA",
            "postal_code": "159466546",
            "telephone_number": "814-736-9614",
            "fax_number": "814-736-9783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERARDINELLI",
        "first_name": "SUSAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA002245L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, PA

Sources for this page

Verify at the official NPI Registry.