Individual provider Active NPI

Flavie Lesage Justafort, P.A.

  • Physician Assistant
  • Lancaster, PA
National Provider Identifier
1164610143
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA053246 Issued in PA
Practice address
313 W Liberty St
Lancaster, PA 17603-2798
Phone
(717) 978-3052
NPI assigned
Oct 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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 MA053246 PA Primary

Addresses

Primary practice location

313 W Liberty St
Lancaster, PA 17603-2798

Mailing address

313 W Liberty St
Lancaster, PA 17603-2798
Phone (179) 783-0527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080811000125 PA Practitioner - Physician Assistant 6406920313 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA053246PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Reading Hospital CurrentSince Sep 1, 2007 Accepting new patients
Wellness Place of Lancaster LLC Physician Assistant Current Accepting new patients
Reading Hospital CurrentSince Sep 1, 2007 Accepting new patients
Tower Health Medical Group CurrentSince Jul 1, 2017 Accepting new patients
Tower Health Medical Group CurrentSince Jul 1, 2017 Accepting new patients
Red Rose Emergency Physicians LLC Physician Assistant Past Accepting new patients
New Jersey/Pennsylvania Em-I Medical Services, P.C. Physician Assistant Past Accepting new patients
Conestoga Emergency Physicians LLC Physician Assistant Past Accepting new patients

Locations

420 S 5th Ave
West Reading, PA 19611
Phone (484) 628-3637

206 S 6th Ave
West Reading, PA 19611
Phone (484) 628-5437

301 S 7th Ave
Ste 130
West Reading, PA 19611
Phone (610) 988-4630

6 Spruce St
West Reading, PA 19611
Phone (484) 628-8269

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1164610143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 W LIBERTY ST",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176032798",
            "telephone_number": "179-783-0527",
            "fax_number": "717-824-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 W LIBERTY ST",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176032798",
            "telephone_number": "717-978-3052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTAFORT",
        "first_name": "FLAVIE",
        "middle_name": "LESAGE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-04",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA053246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.