Individual provider Active NPI

Lisa M. Leitzell, CRNP

  • Obstetrics & Gynecology Nurse Practitioner
  • York, PA
National Provider Identifier
1174876940
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
SP012407 Issued in PA
Practice address
1693 S Queen St
York, PA 17403-4609
Phone
(717) 845-1621
Fax
(717) 854-6939
NPI assigned
Oct 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X SP012407 PA Primary

Addresses

Primary practice location

1693 S Queen St
York, PA 17403-4609

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 845-1621

Other identifiers 1

IdentifierTypeStateIssuer
103037670MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130516000112 PA Practitioner - Nurse Practitioner 4385881093 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

450 S Washington St
Suite B
Gettysburg, PA 17325-2500
Phone (717) 337-4487

Hospital & facility affiliations

  • Wellspan York Hospital Hospital, York, PA, CCN 390046
  • Gettysburg Hospital Hospital, Gettysburg, PA, CCN 390065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services Nurse Practitioner CurrentSince Sep 1, 2015 Accepting new patients
Wellspan Medical Group CurrentSince Feb 22, 2021 Accepting new patients
Pinnacle Health Medical Services CurrentSince Sep 1, 2015 Accepting new patients
Wellspan Medical Group CurrentSince Feb 22, 2021 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Pinnacle Health Medical Services Current Accepting new patients

Locations

1 Trinity Dr E
Ste 120
Dillsburg, PA 17019
Phone (717) 231-8341

450 S Washington St
Ste B
Gettysburg, PA 17325
Phone (717) 337-4487

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

100 S 2nd St
Ste 4A
Harrisburg, PA 17101
Phone (717) 231-8341

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

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

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

1693 S Queen St
York, PA 17403
Phone (717) 356-5330

Interoperability endpoints

  • Direct secure messaging: lleitzell274034@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 6

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

NPI Registry JSON

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1174876940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-845-1621",
            "fax_number": "717-845-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1693 S QUEEN ST",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174034609",
            "telephone_number": "717-845-1621",
            "fax_number": "717-854-6939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEITZELL",
        "first_name": "LISA",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "PA",
            "license": "SP012407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103037670",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.