Organization Active NPI

Evangelical-Geisinger Health, LLC

  • Clinic/Center
  • Lewisburg, PA
National Provider Identifier
1154766251
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
EVANGELICAL-GEISINGER HEALTH, LLC
Practice address
1 Dent Dr
Lewisburg, PA 17837-2005
Phone
(570) 577-1401
Fax
(570) 577-3570
NPI assigned
May 2, 2013
Last updated
Mar 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Authorized official

Name
Stephen M Massini
Title
Cfo
Phone
(570) 214-6181

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

1 Dent Dr
Lewisburg, PA 17837-2005

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6211

Other practice location 1

701 Moore Ave
Lewisburg, PA 17837-2010
Phone (570) 577-1401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131212000116 PA Part B Supplier - Clinic/Group Practice 5991932295 Receives reassigned benefits from 4 practitioners
Practice locations: Lewisburg, PA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0699328Evangelical - Geisinger Health701 Moore Avenue, Lewisburg, PA 17837Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory

Locations

1 Dent Dr
Lewisburg, PA 17837
Phone (570) 577-1401

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1367452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616112000000",
    "number": "1154766251",
    "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": "570-271-6211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DENT DR",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178372005",
            "telephone_number": "570-577-1401",
            "fax_number": "570-577-3570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Moore Ave",
            "address_purpose": "LOCATION",
            "city": "Lewisburg",
            "state": "PA",
            "postal_code": "178372010",
            "country_code": "US",
            "telephone_number": "570-577-1401",
            "fax_number": "570-577-3570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EVANGELICAL-GEISINGER HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-02",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A",
        "authorized_official_last_name": "MASSINI",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "570-214-6181"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.