NPIMap

Individual provider Active NPI

Mark Andrew Blakeslee, D.O.

  • Neurology Physician
  • Lewisburg, PA
National Provider Identifier
1154340461
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
OS007656L Issued in PA
Practice address
3 Hospital Dr Ste 212
Lewisburg, PA 17837-9394
Phone
(570) 522-9771
Fax
(570) 522-9772
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X OS007656L PA
Neurology Physician 2084N0400X OS007656L PA Primary

Addresses

Primary practice location

3 Hospital Dr Ste 212
Lewisburg, PA 17837-9394

Mailing address

1 Hospital Dr Ste 306
Lewisburg, PA 17837-9350
Phone (570) 522-4110

Other identifiers 9

IdentifierTypeStateIssuer
P00170649OtherPARAILROAD MEDICARE
645269046OtherPAGEISINGER
50002761OtherPAKEYSTONE
118438711OtherPADEPARTMENT OF LABOR
170622OtherPABLUE SHIELD
18423860001MedicaidPA
50002761OtherPACAPITAL BLUE CROSS
232809429OtherPATRICARE
G47849OtherPAHEALTH AMERICA

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
I20040127000507 PA Practitioner - Neurology 9931001112 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Philadelphia College of Osteopathic Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians
Evangelical Medical Services OrganizationGroup PAC ID 9133033087, 255 clinicians

Practice addresses (Care Compare)

1 Hospital Dr
Lewisburg, PA 17837-9350
Phone (570) 522-4264

25 Monument Rd
York, PA 17403-5073

3 Hospital Dr
Lewisburg, PA 17837-9362
Phone (570) 524-6974

3 Hospital Dr
Lewisburg, PA 17837-9394

Hospital & facility affiliations

  • Wellspan Evangelical Community Hospital Hospital, Lewisburg, PA, CCN 390013
  • Geisinger Medical Center Hospital, Danville, PA, CCN 390006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS007656LPAMDSleep Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Evangelical Medical Services Organization CurrentSince Nov 14, 2000 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince Dec 1, 2025 Accepting new patients
Evangelical Medical Services Organization Neurology CurrentSince Nov 14, 2000 Accepting new patients
Wellspan Medical Group CurrentSince Dec 1, 2025 Accepting new patients
Wellspan Medical Group Past Accepting new patients

Locations

1 Hospital Dr
Lewisburg, PA 17837
Phone (570) 522-2000

3 Hospital Dr
Ste 318
Lewisburg, PA 17837
Phone (570) 522-1007

3 Hospital Dr
Ste 212
Lewisburg, PA 17837
Phone (570) 522-9771

1 Hospital Dr
Ste 306
Lewisburg, PA 17837
Phone (570) 522-4110

25 Lystra Rogers Dr
Lewisburg, PA 17837
Phone (570) 523-3290

3 Hospital Dr
Ste 306
Lewisburg, PA 17837
Phone (570) 522-9771

3 Hospital Dr
Ste 204
Lewisburg, PA 17837
Phone (570) 522-2990

3 Hospital Dr
Ste 206
Lewisburg, PA 17837
Phone (570) 522-9771

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

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

Interoperability endpoints

  • Direct secure messaging: mblakeslee485125@wellspan.direct-ci.com

Organizations & group practices 6

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 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1154340461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR STE 306",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178379350",
            "telephone_number": "570-522-4110",
            "fax_number": "570-768-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 HOSPITAL DR STE 212",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178379394",
            "telephone_number": "570-522-9771",
            "fax_number": "570-522-9772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKESLEE",
        "first_name": "MARK",
        "middle_name": "ANDREW",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "PA",
            "license": "OS007656L",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "OS007656L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00170649",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "645269046",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "50002761",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "118438711",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "170622",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18423860001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50002761",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "232809429",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA",
            "identifier": "G47849",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, PA

Sources for this page

Verify at the official NPI Registry.