Individual provider Active NPI

Siobhan Bross Stoltzfus, CRNP, AANP

  • Nurse Practitioner
  • Bloomsburg, PA
National Provider Identifier
1093604258
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP033249 Issued in PA
Practice address
240 Mall Blvd
Bloomsburg, PA 17815-8306
Phone
(570) 416-8200
Fax
(570) 416-8210
NPI assigned
Jul 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP033249 PA Primary

Addresses

Primary practice location

240 Mall Blvd
Bloomsburg, PA 17815-8306

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 416-8200

Other names 1

  • Siobhan Bross Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251024003558 PA Practitioner - Nurse Practitioner 9537657002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

240 Mall Blvd
Bloomsburg, PA 17815-8389
Phone (570) 416-5435

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP033249PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Sep 21, 2025 Accepting new patients
Geisinger Clinic CurrentSince Sep 21, 2025 Accepting new patients
Geisinger Clinic Nurse Practitioner Current Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

65 Briar Creek Plz
Berwick, PA 18603
Phone (570) 802-5590

240 Mall Blvd
Bloomsburg, PA 17815
Phone (570) 416-5435

100 N Academy Ave
Danville, PA 17822

175 Northumberland St
Danville, PA 17821
Phone (570) 284-4575

10990 State Route 61
Mount Carmel, PA 17851
Phone (570) 339-4513

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1751328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1093604258",
    "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": "570-416-8200",
            "fax_number": "570-416-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MALL BLVD",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178158306",
            "telephone_number": "570-416-8200",
            "fax_number": "570-416-8210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLTZFUS",
        "first_name": "SIOBHAN",
        "middle_name": "BROSS",
        "name_prefix": "Dr.",
        "credential": "CRNP, AANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-01",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP033249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SIOBHAN",
            "last_name": "BROSS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bloomsburg, PA

Sources for this page

Verify at the official NPI Registry.