NPIMap

Individual provider Active NPI

Laura Dianne Laidacker Fike, PA-C

  • Physician Assistant
  • Danville, PA
National Provider Identifier
1164845251
Registry record updated Apr 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA056698 Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-9800
Phone
(570) 441-2163
NPI assigned
Jan 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA056698 PA
Physician Assistant 363A00000X MA056698 PA Primary

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-9800

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other names 1

  • Laura Moore Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lmoore114540@direct.geisinger.edu Direct

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
I20140307000088 PA Practitioner - Physician Assistant 0941430268 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger-HM Joint Venture LLCGroup PAC ID 1355676370, 426 clinicians
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

10 Choate Cir
Montoursville, PA 17754-9791
Phone (570) 368-5566

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA056698PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger-HM Joint Venture, LLC Physician Assistant CurrentSince Jan 10, 2022 Accepting new patients
Geisinger-HM Joint Venture, LLC Physician Assistant CurrentSince Jan 10, 2022 Accepting new patients
Geisinger Clinic CurrentSince Mar 1, 2014 Accepting new patients
Geisinger Clinic CurrentSince Mar 1, 2014 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

4200 Hospital Rd
Coal Township, PA 17866
Phone (570) 644-4200

16 Woodbine Ln
Danville, PA 17821
Phone (570) 271-6531

100 N Academy Ave
Danville, PA 17822

400 Highland Ave
Lewistown, PA 17044
Phone (717) 242-7473

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

255 Route 220 Hwy
Ste 205
Muncy, PA 17756
Phone (570) 308-2445

132 Abigail Ln
Port Matilda, PA 16870
Phone (814) 272-5011

529 Terry Reiley Way
Pottsville, PA 17901
Phone (570) 624-4120

Organizations & group practices 7

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": "1390780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1164845251",
    "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": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178229800",
            "telephone_number": "570-441-2163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIKE",
        "first_name": "LAURA",
        "middle_name": "DIANNE LAIDACKER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-27",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA056698",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA056698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmoore114540@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 N Academy Ave",
            "city": "Danville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178229800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "MOORE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.