Geisinger Clinic
Organization Active NPI Family Medicine Physician · Danville, PA
NPI 1164716643 · NPPES record last updated Jul 1, 2025
Key facts
- NPI
- 1164716643
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- GEISINGER CLINIC
- Practice address
- 175 Northumberland Street
Danville, PA 17821-1508 - Phone
- (570) 284-4575
- Fax
- (570) 284-4577
- NPI assigned
- Jun 2, 2011
- Organization subpart
- No
Authorized official
- Name
- Mrs. Cindy Mull
- Title
- Director
- Phone
- (570) 271-6144
Other NPIs on the same Medicare enrollment 3
Corporate family (same tax ID) 24
Practitioners 76
-
Ammar Alimam, MD
-
Sidra Anwar, M.D.
-
Cory Balko, CRNP
-
Vicky H Bhagat, M.D.
-
Chris C Capelli, DO
-
Stephanie Carpenter, PA-C
-
Arina Chesnokova, MD MPH
-
Andrew R Conger, M.D.
-
Alexa Anne Connors, PA-C
-
Matthew Michael Cummings, PA-C
-
M Jane D'Alessandro, NP-C
-
Grace Joy Dacey, PA-C
-
C. Liam Dwyer, MD
-
Lauryn Alissa Eister, CRNP
-
Hany Eskarous, MD
-
Patricia Ann Fogelman, DNP, CRNP
-
Jon D Gabrielsen, M.D.
-
Pradeepto Ghosh, M.D.
-
John Joseph Haber, D.O.
-
John J Han, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in PA, VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040130000518 | PA | Part B Supplier - Clinic/Group Practice | 5395657001 |
Receives reassigned benefits from 5,323 practitioners This NPI is an additional NPI on the enrollment |
| O20181220001991 | VA | Part B Supplier - Clinic/Group Practice | 5395657001 |
Receives reassigned benefits from 24 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Norfolk, VA; Penn Laird, VA; Reston, VA; Richmond, VA; Roanoke, VA; Salem, VA; Virginia Beach, VA; Sterling, VA… |
National Provider Directory
- Tax ID family
- Geisinger Clinic Sunbury
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
175 Northumberland Street
Danville, PA 17821-1508
Mailing address
100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6211
Other practice location 1
410 Glen Ave
Bloomsburg, PA 17815-1200
Phone (570) 416-1890
Other practice location 2
631 Northern Blvd
South Abington Township, PA 18410
Phone (570) 587-2290
Other practice location 3
2631 US 11
Nicholson, PA 18446-0591
Phone (570) 942-6124
Other practice location 4
5 Lakeview Dr
Moosic, PA 18507-2108
Phone (570) 558-2186
Other practice location 5
10990 Rt 61
Mt Carmel, PA 17851-2575
Phone (570) 554-9270
Other practice location 6
1151 N. 4th Street
Sunbury, PA 17801-1221
Phone (570) 556-4900
Other practice location 7
114 Lt Michael Cleary Dr
Dallas, PA 18612-3828
Phone (570) 255-1178
Other practice location 8
809 Hunter Highway
Tunkhannock, PA 18657-8071
Phone (570) 996-2700
Other providers in Danville, PA
- Geisinger Clinic
- Geisinger Clinic
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- Geisinger Clinic
- Geisinger Clinic
- Geisinger Clinic
- Geisinger Clinic
- Geisinger Clinic
- Geisinger Clinic
- Geisinger Clinic
All providers in Danville, PA · Family Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.