Abigail Clemens, PA
Individual provider Active NPI Medical Physician Assistant · Marietta, PA
NPI 1053034827 · NPPES record last updated Aug 28, 2024
Key facts
- NPI
- 1053034827
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- MA064739 (PA)
- Practice address
- 1159 River Rd
Marietta, PA 17547-1628 - Phone
- (717) 426-1131
- NPI assigned
- Sep 26, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
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: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231212003612 | PA | Practitioner - Physician Assistant | 3476902792 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA064739 | PA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lancaster General Medical Group | Current |
Accepting new patients | |
| Lancaster General Medical Group | Current |
Accepting new patients |
Locations
3045 Marietta Ave
Lancaster, PA 17601
Phone (717) 299-4644
555 N Duke St
Lancaster, PA 17602
Phone (717) 544-5945
1159 River Rd
Marietta, PA 17547
Phone (717) 426-1131
1159 River Rd
#F
Marietta, PA 17547
Phone (717) 426-1131
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | MA064739 | PA | Yes |
Addresses
Primary practice location
1159 River Rd
Marietta, PA 17547-1628
Mailing address
123 Summer House LN
York, PA 17408-4294
Phone (717) 792-4005
Other providers in Marietta, PA
- Eric Scott Brecher
- Robert H Brewer
- Caroline Reist Buckwalter
- Jamie Lynn Burg
- Calico Wellness Collective, LLC
- Hilda Colon
- Camden A Cook
- Drayer Physical Therapy Institute LLC
- Zachary Fair
- Keith Foundling
All providers in Marietta, PA · Medical Physician Assistant in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.