Individual provider Active NPI

Micaela Graber, PAC

  • Physician Assistant
  • Lancaster, PA
National Provider Identifier
1124586474
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA060542 Issued in PA
Practice address
170 N Pointe Blvd
Lancaster, PA 17601-4132
Phone
(717) 299-4871
Fax
(717) 391-2494
NPI assigned
Mar 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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 MA060542 PA Primary

Addresses

Primary practice location

170 N Pointe Blvd
Lancaster, PA 17601-4132

Mailing address

170 N Pointe Blvd
Lancaster, PA 17601-4132
Phone (717) 299-4871

Other practice location 1

9104 Babcock Blvd
Medical Arts Building T 5TH Floor
Pittsburgh, PA 15237-5818
Phone (412) 748-7190

Other practice location 2

212 Willow Valley Lakes Dr Ste 201
Willow Street, PA 17584-9668
Phone (717) 299-4871

Other practice location 3

2913 Spooky Nook Rd Ste 100
Manheim, PA 17545-9149
Phone (717) 299-4871

Other practice location 4

1701 Cornwall Rd Ste 200
Lebanon, PA 17042-7480
Phone (717) 299-4871

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
I20190410000852 PA Practitioner - Physician Assistant 3072854546 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic Assoc of Lancaster LTDGroup PAC ID 8527041987, 81 clinicians

Practice addresses (Care Compare)

170 N Pointe Blvd
Lancaster, PA 17601-4132
Phone (717) 299-4871

Hospital & facility affiliations

  • Lancaster General Hospital Hospital, Lancaster, PA, CCN 390100
  • Wellspan Ephrata Community Hospital Hospital, Ephrata, PA, CCN 390225

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA060542PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Community Medcine Inc CurrentSince Apr 1, 2019 Accepting new patients
Upmc Community Medicine Inc CurrentSince Apr 1, 2019 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

875 N Hermitage Rd
Ste 3
Hermitage, PA 16148
Phone (724) 347-4622

9104 Babcock Blvd
Ste 5113
Pittsburgh, PA 15237
Phone (412) 364-4184

9104 Babcock Blvd
Bldg T
Pittsburgh, PA 15237
Phone (412) 748-7190

339 6th Ave
Fl 5
Pittsburgh, PA 15222
Phone (412) 560-8762

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1124586474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 N POINTE BLVD",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176014132",
            "telephone_number": "717-299-4871",
            "fax_number": "717-391-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 N POINTE BLVD",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176014132",
            "telephone_number": "717-299-4871",
            "fax_number": "717-391-2494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9104 Babcock Blvd",
            "address_2": "MEDICAL ARTS BUILDING T 5TH FLOOR",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152375818",
            "country_code": "US",
            "telephone_number": "412-748-7190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "212 Willow Valley Lakes Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Willow Street",
            "state": "PA",
            "postal_code": "175849668",
            "country_code": "US",
            "telephone_number": "717-299-4871",
            "fax_number": "717-391-2494",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2913 Spooky Nook Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Manheim",
            "state": "PA",
            "postal_code": "175459149",
            "country_code": "US",
            "telephone_number": "717-299-4871",
            "fax_number": "717-391-2494",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 Cornwall Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170427480",
            "country_code": "US",
            "telephone_number": "717-299-4871",
            "fax_number": "717-391-2494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRABER",
        "first_name": "MICAELA",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-06",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA060542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.