NPIMap

Individual provider Active NPI

Pedro O. Servano III, M.D.

  • Family Medicine Physician
  • Selinsgrove, PA
National Provider Identifier
1134186240
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD054558L Issued in PA
Practice address
201 Roosevelt Ave
Selinsgrove, PA 17870-7969
Phone
(570) 374-0151
Fax
(570) 374-0311
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD054558L PA Primary

Addresses

Primary practice location

201 Roosevelt Ave
Selinsgrove, PA 17870-7969

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other identifiers 1

IdentifierTypeStateIssuer
001548445MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pservano61671@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050117000435 PA Practitioner - Family Practice 3072562057 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

250 Reitz Blvd
Lewisburg, PA 17837-9208
Phone (570) 523-0055

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD054558LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger-HM Joint Venture, LLC Family Medicine CurrentSince Mar 3, 2022 Accepting new patients
Geisinger-HM Joint Venture, LLC Family Medicine CurrentSince Mar 3, 2022 Accepting new patients
Geisinger Clinic CurrentSince Apr 1, 2016 Accepting new patients
Geisinger-HM Joint Venture, LLC Family Medicine Current Accepting new patients
Geisinger Clinic Sunbury Family Medicine Current Accepting new patients
Geisinger Clinic Family Medicine Current Accepting new patients
Geisinger Clinic Past Accepting new patients
Geisinger Clinic Selinsgrove Family Medicine Past Accepting new patients
Penn Village Facility Operations, LLC Past Accepting new patients
51 Route 204 Opco LLC Past Accepting new patients

Locations

42 N Scott St
Carbondale, PA 18407
Phone (570) 282-6660

100 N Academy Ave
Danville, PA 17822

100 N Academy Ave
#43
Danville, PA 17822
Phone (570) 271-6304

250 Reitz Blvd
Lewisburg, PA 17837
Phone (570) 523-0055

155 S Arch St
Ste B
Milton, PA 17847
Phone (570) 742-2655

780 Broad St
Montoursville, PA 17754
Phone (570) 368-2870

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

255 Route 220 Hwy
Muncy, PA 17756
Phone (570) 308-2600

201 Roosevelt Ave
Selinsgrove, PA 17870
Phone (570) 372-8803

1151 N 4th St
Sunbury, PA 17801
Phone (570) 286-6773

385 State St
Sunbury, PA 17801
Phone (570) 286-6773

Interoperability endpoints

  • Direct secure messaging: pservano61671@direct.geisinger.edu

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.

Hospital & facility affiliations 30

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1134186240",
    "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": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 ROOSEVELT AVE",
            "city": "SELINSGROVE",
            "state": "PA",
            "postal_code": "178707969",
            "telephone_number": "570-374-0151",
            "fax_number": "570-374-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERVANO",
        "first_name": "PEDRO",
        "middle_name": "O.",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD054558L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001548445",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pservano61671@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "201 Roosevelt Ave",
            "city": "Selinsgrove",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178707969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Selinsgrove, PA

Sources for this page

Verify at the official NPI Registry.