Individual provider Active NPI

Maria Mabel Fasano, M.D.

  • Clinical Pathology Physician
  • Lewisburg, PA
National Provider Identifier
1083634018
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology PhysicianTaxonomy code 207ZC0006X
License
MD067300L Issued in PA
Practice address
1 Hospital Dr
Lewisburg, PA 17837-9314
Phone
(570) 522-4110
Fax
(570) 768-3911
NPI assigned
Jul 20, 2006
Last updated
May 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X MD067300L PA
Anatomic Pathology Physician 207ZP0101X MD067300L PA
Clinical Pathology Physician 207ZC0006X MD067300L PA Primary

Addresses

Primary practice location

1 Hospital Dr
Lewisburg, PA 17837-9314

Mailing address

1 Hospital Dr Ste 306
Lewisburg, PA 17837-9350
Phone (570) 522-4110

Other identifiers 5

IdentifierTypeStateIssuer
17314940004MedicaidPA
232809429OtherPATRICARE
321847OtherPAHEALTH AMERICA
540643OtherPABLUE SHIELD
220025023OtherPARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061006000029 PA Practitioner - Pathology 5496751935 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Hospital Dr
Lewisburg, PA 17837-9350
Phone (570) 522-2641

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD067300LPAMDCytopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Evangelical Medical Services Organization CurrentSince Jan 4, 1999 Accepting new patients
Wellspan Medical Group CurrentSince Dec 1, 2025 Accepting new patients
Evangelical Medical Services Organization Current Accepting new patients
Evangelical Medical Services Organization Cytopathology CurrentSince Jan 4, 1999 Accepting new patients
Wellspan Medical Group CurrentSince Dec 1, 2025 Accepting new patients
Wellspan Medical Group Current Accepting new patients

Locations

1 Hospital Dr
Lewisburg, PA 17837
Phone (570) 522-2000

1 Hospital Dr
Ste 306
Lewisburg, PA 17837
Phone (570) 522-4110

25 Lystra Rogers Dr
Lewisburg, PA 17837
Phone (570) 523-3290

3 Hospital Dr
Ste 206
Lewisburg, PA 17837
Phone (570) 522-9771

3 Hospital Dr
Ste 318
Lewisburg, PA 17837
Phone (570) 522-1007

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Evangelical Community HospitalLewisburg, PA, CCN 390013 Hospital Corporate Officer Jan 1, 2025
Evangelical Community HospitalLewisburg, PA, CCN 39T013 Hospital Corporate Officer Jan 1, 2025
Wellspan Hospice ServicesLewisburg, PA, CCN 391545 Hospice Corporate Officer Jan 1, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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 1

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1083634018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR STE 306",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178379350",
            "telephone_number": "570-522-4110",
            "fax_number": "570-768-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178379314",
            "telephone_number": "570-522-4110",
            "fax_number": "570-768-3911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASANO",
        "first_name": "MARIA",
        "middle_name": "MABEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "PA",
            "license": "MD067300L",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "PA",
            "license": "MD067300L",
            "primary": false
        },
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "PA",
            "license": "MD067300L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17314940004",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "232809429",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA",
            "identifier": "321847",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "540643",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "220025023",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, PA

Sources for this page

Verify at the official NPI Registry.