Andrea Marie Requa, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS007422E Issued in PA

Practice address

5125 Jonestown Rd Ste 105
Harrisburg, PA 17112-2987

Phone

(717) 943-1566

Fax

(717) 943-1567

NPI assigned

Apr 12, 2006

Last updated

Oct 19, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Pennsylvania Department of Human Services

  dba Torrance State Hospital

  • Psychiatric Hospital
  • Torrance, PA
  • NPI 1376526111
  Medicare reassignment NPD
• Pennsylvania Department of Public Welfare

  dba Allentown State Hospital

  • Psychiatric Hospital
  • Allentown, PA
  • NPI 1386626919
  NPD
• Spirit Physician Services Inc.

  • Diagnostic Radiology Physician
  • Camp Hill, PA
  • NPI 1275072662
  NPD (past)

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1144284654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 758952",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212758952",
            "telephone_number": "804-968-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5125 JONESTOWN RD STE 105",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171122987",
            "telephone_number": "717-943-1566",
            "fax_number": "717-943-1567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REQUA",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS007422E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven M Remillard, D.C.
• Renal Care Group East, Inc. (Fresenius Medical Care City Line Dialysis)
• Renal Treatment Centers Mid Atlantic Inc (Rutherford Dialysis)
• Renewed Perspectives Mental Health Solutions LLC
• Colleen Rengert, MS
• Bethany Alycia Restemayer, M.D.
• Resurgence Family Preservation Services, LLC (Resurgence Family Preservation Services)
• Daniel Braden Reubens, DPM
• Avia Reuveni, DPM
• Melissa Brigette Revens, LPN

• Family Medicine Physician in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.