Active NPI
Amy J Nissley, PA-C
- Physician Assistant
- Harrisburg, PA
National Provider Identifier
1104074871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA053531
- Practice address
- 111 S Front St
Harrisburg, PA 17101-2010 - Phone
- (717) 782-3380
- NPI assigned
- Sep 5, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA053531 | PA | Primary |
| Medical Physician Assistant | 363AM0700X | OA002306 | PA |
Addresses
Primary practice location
111 S Front St
Harrisburg, PA 17101-2010
Mailing address
111 S Front St
Harrisburg, PA 17101-2010
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103146807 | Medicaid | PA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | anissley8183@phsdirect.pinnaclehealth.org |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081230000477 | PA | Practitioner - Physician Assistant | 5799847612 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 93.46 of 100
- Quality
- 92.17
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 78.87
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA053531 | PA | MD | Physician Assistant |
| OA002306 | PA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Urgent Care Center of Lancaster, LLC | Past | Accepting new patients |
Interoperability endpoints
- anissley298294@upmc.direct-ci.com
Organizations & group practices 2
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.
-
- Emergency Medicine Physician
- Harrisburg, PA
- NPI 1487693404
PA
-
- Urgent Care Clinic/Center
- Gap, PA
- NPI 1376799429
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618444800000",
"number": "1104074871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 S FRONT ST",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171012010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 S FRONT ST",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171012010",
"telephone_number": "717-782-3380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NISSLEY",
"first_name": "AMY",
"middle_name": "J",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-05",
"last_updated": "2021-04-15",
"certification_date": "2021-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA053531",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "OA002306",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103146807",
"state": "PA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "anissley8183@phsdirect.pinnaclehealth.org",
"affiliation": "N",
"address_1": "111 S Front St",
"city": "Harrisburg",
"state": "PA",
"country_code": "US",
"postal_code": "171012010",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Harrisburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.