Individual provider Active NPI

Mary Rachel Walters, PA-C

  • Physician Assistant
  • Danville, PA
National Provider Identifier
1245541754
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA054361 Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-2170
Phone
(570) 271-6361
Fax
(570) 271-5785
NPI assigned
Jun 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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 MA054361 PA Primary

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-2170

Mailing address

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

Other names 1

  • Mary Rachel Wolf Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mwolf88279@direct.geisinger.edu Direct

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
I20100913000800 PA Practitioner - Physician Assistant 4082739164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA054361PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Aug 1, 2010 Accepting new patients
Geisinger Clinic Physician Assistant CurrentSince Aug 1, 2010 Accepting new patients
Geisinger Clinic Past Accepting new patients
Geisinger-HM Joint Venture, LLC Physician Assistant Past Accepting new patients

Locations

439 E 1st St
Bloomsburg, PA 17815
Phone (570) 387-1444

100 N Academy Ave
Danville, PA 17822

1020 Thompson St
Jersey Shore, PA 17740
Phone (570) 398-0100

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

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

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

1800 Mulberry St
Scranton, PA 18510
Phone (570) 703-7351

25 Church St
Wilkes Barre, PA 18702
Phone (570) 340-5800

1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300

Interoperability endpoints

  • Direct secure messaging: mwolf88279@direct.geisinger.edu

Organizations & group practices 5

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": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1245541754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "address_2": "CREDENTIALS DEPT",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "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": "178222170",
            "telephone_number": "570-271-6361",
            "fax_number": "570-271-5785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "MARY",
        "middle_name": "RACHEL",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA054361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwolf88279@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 N Academy Ave",
            "city": "Danville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178222170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "WOLF",
            "middle_name": "RACHEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.