NPIMap

Individual provider Active NPI

Joanna Grzadziel, DO

  • Family Medicine Physician
  • Leesport, PA
National Provider Identifier
1073900270
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS020821 Issued in PA
Practice address
5 S Centre Ave Ste A3
Leesport, PA 19533-8661
Phone
(610) 926-5707
Fax
(610) 926-8352
NPI assigned
Apr 25, 2015
Reactivated
May 1, 2017
Last updated
Dec 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS020821 PA Primary

Addresses

Primary practice location

5 S Centre Ave Ste A3
Leesport, PA 19533-8661

Mailing address

5 S Centre Ave Ste A3
Leesport, PA 19533-8661
Phone (610) 926-5707

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
I20200828000008 PA Practitioner - Family Practice 5496023517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

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

5 S Centre Ave
Suite A3 Pshmg Schuylkill Valley
Leesport, PA 19533-8661
Phone (610) 926-5707

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
65.84
Promoting interoperability
100
Improvement activities
40
Cost
77

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Penn State Health Medical Group, LLC CurrentSince Sep 25, 2020 Accepting new patients
Penn State Health Medical Group, LLC Current Accepting new patients
Penn State Health Medical Group, LLC Past Accepting new patients
Penn State Health Medical Group, LLC PastSince Dec 9, 2019 Accepting new patients

Locations

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

5 S Centre Ave
Ste A3
Leesport, PA 19533
Phone (610) 921-6570

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1429920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1073900270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 S CENTRE AVE STE A3",
            "city": "LEESPORT",
            "state": "PA",
            "postal_code": "195338661",
            "telephone_number": "610-926-5707",
            "fax_number": "610-926-8352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 S CENTRE AVE STE A3",
            "city": "LEESPORT",
            "state": "PA",
            "postal_code": "195338661",
            "telephone_number": "610-926-5707",
            "fax_number": "610-926-8352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRZADZIEL",
        "first_name": "JOANNA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-25",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "deactivation_date": "2016-09-14",
        "reactivation_date": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS020821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesport, PA

Sources for this page

Verify at the official NPI Registry.