NPIMap

Individual provider Active NPI

Colt Brackbill, PA-C

  • Physician Assistant
  • Lewistown, PA
National Provider Identifier
1063993707
Registry record updated Aug 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
OA004574 Issued in PA
Practice address
21 Geisinger LN
Lewistown, PA 17044-3400
Phone
(717) 242-4200
Fax
(717) 242-4212
NPI assigned
Aug 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OA004574 PA
Physician Assistant 363A00000X OA004574 PA Primary

Addresses

Primary practice location

21 Geisinger LN
Lewistown, PA 17044-3400

Mailing address

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

Other practice location 1

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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cbrackbill169600@direct.geisinger.edu Direct

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
I20180919000724 PA Practitioner - Physician Assistant 6901157676 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

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

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

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

27 Cjems LN
Suite 4
Mifflintown, PA 17059-8384
Phone (717) 436-5578

Hospital & facility affiliations

  • Geisinger Home Health Home health agency, Danville, PA, CCN 397718
  • Centre Homecare Inc Home health agency, State College, PA, CCN 397126
  • Geisinger-Lewistown Hospital Hospital, Lewistown, PA, CCN 390048
  • Upmc Pinnacle Hospitals Hospital, Harrisburg, PA, CCN 390067

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OA004574PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger-HM Joint Venture, LLC Family Medicine CurrentSince Mar 22, 2021 Accepting new patients
Family Health Associates of Lewistown Family Medicine CurrentSince Sep 17, 2018 Accepting new patients
Emergency Care Services of Pennsylvania, P.C. Physician Assistant CurrentSince Mar 21, 2020 Accepting new patients
Geisinger-HM Joint Venture, LLC Family Medicine CurrentSince Mar 22, 2021 Accepting new patients
Geisinger Clinic CurrentSince Sep 17, 2018 Accepting new patients
Geisinger Clinic CurrentSince Sep 17, 2018 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

5 Hedgeapple Dr
Belleville, PA 17004
Phone (717) 667-9030

4752 State Route 655
Belleville, PA 17004
Phone (717) 667-9030

224 N Logan Blvd
Burnham, PA 17009
Phone (717) 242-0196

100 N Academy Ave
Danville, PA 17822

400 Highland Ave
Lewistown, PA 17044
Phone (717) 242-7473

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

56 Jam House Rd
Mifflin, PA 17058
Phone (717) 436-8986

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

10 Gateway Dr
Reedsville, PA 17084
Phone (717) 363-9300

611 University Dr
State College, PA 16801
Phone (814) 234-2600

1630 N Atherton St
State College, PA 16803
Phone (814) 238-1279

Interoperability endpoints

  • Direct secure messaging: cbrackbill169600@direct.geisinger.edu

Organizations & group practices 9

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598745600000",
    "number": "1063993707",
    "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": "21 GEISINGER LN",
            "city": "LEWISTOWN",
            "state": "PA",
            "postal_code": "170443400",
            "telephone_number": "717-242-4200",
            "fax_number": "717-242-4212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Geisinger Ln",
            "address_purpose": "LOCATION",
            "city": "Lewistown",
            "state": "PA",
            "postal_code": "170443400",
            "country_code": "US",
            "telephone_number": "717-242-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRACKBILL",
        "first_name": "COLT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-21",
        "last_updated": "2020-08-30",
        "certification_date": "2020-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OA004574",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA004574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cbrackbill169600@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "21 Geisinger Ln",
            "city": "Lewistown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170443400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lewistown, PA

Sources for this page

Verify at the official NPI Registry.