Individual provider Active NPI

Sarah E. Moncado, PA-C

  • Physician Assistant
  • Williamsport, PA
National Provider Identifier
1104103969
Registry record updated Jul 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA055215 Issued in PA
Practice address
1100 Grampian Blvd
Williamsport, PA 17701-1909
Phone
(570) 326-8470
Fax
(570) 326-8590
NPI assigned
Nov 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA055215 PA Primary

Addresses

Primary practice location

1100 Grampian Blvd
Williamsport, PA 17701-1909

Mailing address

1201 Grampian Blvd
Suite 1K
Williamsport, PA 17701-1900
Phone (570) 326-8723

Other identifiers 2

IdentifierTypeStateIssuer
MA055215OtherPAMEDICAL LICENSE
OA002777OtherPAOSTEOPATHIC LICENSE

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
I20120206000325 PA Practitioner - Physician Assistant 6608033543 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Physician Assistant CurrentSince Apr 4, 2016 Accepting new patients
Tower Health Medical Group CurrentSince Jun 24, 2019 Accepting new patients
Family Health Associates of Lewistown CurrentSince Oct 18, 2017 Accepting new patients
Reading Hospital CurrentSince Jan 6, 2021 Accepting new patients
Geisinger Clinic CurrentSince Apr 4, 2016 Accepting new patients
Tower Health Medical Group CurrentSince Jun 24, 2019 Accepting new patients
Reading Hospital CurrentSince Jan 6, 2021 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

27 Sandy Ln
Ste 140
Lewistown, PA 17044
Phone (717) 242-2711

21 Geisinger Ln
Lewistown, PA 17044
Phone (717) 242-4200

200 Scenery Dr
State College, PA 16801
Phone (814) 231-4560

301 S 7th Ave
Ste 130
West Reading, PA 19611
Phone (610) 988-4630

420 S 5th Ave
Bldg N
West Reading, PA 19611
Phone (484) 628-0900

206 S 6th Ave
West Reading, PA 19611
Phone (484) 628-5437

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

Organizations & group practices 10

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": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406678400000",
    "number": "1104103969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "address_2": "SUITE 1K",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900",
            "telephone_number": "570-326-8723",
            "fax_number": "570-326-8922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011909",
            "telephone_number": "570-326-8470",
            "fax_number": "570-326-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONCADO",
        "first_name": "SARAH",
        "middle_name": "E.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-08",
        "last_updated": "2014-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA055215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MA055215",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OSTEOPATHIC LICENSE",
            "identifier": "OA002777",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

Verify at the official NPI Registry.