Individual provider Active NPI

Rachelle Lynn Ambrose, MD

  • Pediatrics Physician
  • York, PA
National Provider Identifier
1114956612
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD418846 Issued in PA
Practice address
2050 S Queen St
Ste 100
York, PA 17403-4829
Phone
(717) 812-4240
Fax
(717) 848-5520
NPI assigned
Jun 30, 2006
Last updated
Mar 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD418846 PA Primary

Addresses

Primary practice location

2050 S Queen St
Ste 100
York, PA 17403-4829

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 851-1405

Other practice location 1

4020 Carlisle Rd
Dover, PA 17315-3508
Phone (717) 812-4240

Other identifiers 11

IdentifierTypeStateIssuer
281434OtherPAMAMSI-WMG
03163601OtherPACAPITAL BLUE CROSS-WMG
104591OtherPAJOHNS HOPKINS
20016261OtherPAAMERIHEALTH MERCY-WMG CRD
20015715OtherPAAMERIHEALTH MERCY-WMG QST
P004690OtherPAGATEWAY-WMG
129798OtherPAUNISON-WMG
100433OtherPAGEISINGER
1392227OtherPAHIGHMARK BLUE SHIELD
7909460OtherPAAETNA
001886774MedicaidPA

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
I20041213000047 PA Practitioner - Pediatric Medicine 6608833652 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Jan 6, 2010 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Apple Hill Surgical Center Partners CurrentSince Jan 6, 2010 Accepting new patients

Locations

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

1620 S Queen St
York, PA 17403
Phone (717) 843-6663

1803 Mount Rose Ave
Ste B3
York, PA 17403
Phone (717) 851-6816

2050 S Queen St
#100
York, PA 17403
Phone (717) 812-4240

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

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

4020 Carlisle Rd
York, PA 17315
Phone (717) 812-4240

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

Interoperability endpoints

  • Direct secure messaging: rambrose13792@wellspan.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1114956612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405",
            "fax_number": "717-851-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 S QUEEN ST",
            "address_2": "STE 100",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174034829",
            "telephone_number": "717-812-4240",
            "fax_number": "717-848-5520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4020 Carlisle Rd",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "PA",
            "postal_code": "173153508",
            "country_code": "US",
            "telephone_number": "717-812-4240",
            "fax_number": "717-851-6460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMBROSE",
        "first_name": "RACHELLE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD418846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI-WMG",
            "identifier": "281434",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS-WMG",
            "identifier": "03163601",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHNS HOPKINS",
            "identifier": "104591",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY-WMG CRD",
            "identifier": "20016261",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY-WMG QST",
            "identifier": "20015715",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY-WMG",
            "identifier": "P004690",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON-WMG",
            "identifier": "129798",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "100433",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1392227",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7909460",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001886774",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.