Individual provider Active NPI

Dallas Seltzer, PA

  • Medical Physician Assistant
  • Springfield, MA
National Provider Identifier
1073164828
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA061043 Issued in PA
Practice address
3300 Main Street
3Rd FL, Suite C&D
Springfield, MA 01107-1112
Phone
(413) 794-5600
Fax
(413) 794-7297
NPI assigned
Sep 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA061043 PA Primary

Addresses

Primary practice location

3300 Main Street
3Rd FL, Suite C&D
Springfield, MA 01107-1112

Mailing address

280 Chestnut St FL 2
Springfield, MA 01199-1001
Phone (413) 794-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191021000042 PA Practitioner - Physician Assistant 8426389685 Reassigns benefits to 2 organizations
I20231129001962 MA Practitioner - Physician Assistant 8426389685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians

Practice addresses (Care Compare)

280 Chestnut St
Suite 2
Springfield, MA 01199-1001

759 Chestnut St
Springfield, MA 01199-1001
Phone (413) 794-5439

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA061043PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geieinger Clinic CurrentSince Sep 18, 2020 Accepting new patients
Lehigh Valley Physician Group CurrentSince Oct 21, 2019 Accepting new patients
Geisinger Clinic CurrentSince Sep 18, 2020 Accepting new patients
Lehigh Valley Physician Group CurrentSince Oct 21, 2019 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

Organizations & group practices 7

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 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": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1073164828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST FL 2",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 MAIN STREET",
            "address_2": "3RD FL, SUITE C&D",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071112",
            "telephone_number": "413-794-5600",
            "fax_number": "413-794-7297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELTZER",
        "first_name": "DALLAS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-24",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "PA061043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.