NPIMap

Organization Active NPI

Penn State Health Medical Group, LLC

  • Certified Registered Nurse Anesthetist
  • Camp Hill, PA
National Provider Identifier
1255086831
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
PENN STATE HEALTH MEDICAL GROUP, LLC
Practice address
503 N 21St St
Camp Hill, PA 17011-2204
Phone
(717) 972-7919
Fax
(717) 763-2272
NPI assigned
Feb 13, 2022
Last updated
Jul 29, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
PENN STATE HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Authorized official

Name
Tracy L Moyer-Swinko
Title
VP/Chief Financial Officer
Phone
(717) 531-8477

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU Primary

Addresses

Primary practice location

503 N 21St St
Camp Hill, PA 17011-2204

Mailing address

PO Box 825972
Philadelphia, PA 19182-5972
Phone (717) 531-4859

Other practice location 1

413 Granite Run Dr
Lancaster, PA 17601-6809
Phone (717) 560-4200

Other practice location 2

2500 Bernville Rd
Reading, PA 19605-9453
Phone (610) 378-2000

Other practice location 3

810 Plaza Blvd Ste 101
Lancaster, PA 17601-2762
Phone (717) 431-2368

Other practice location 4

2200 Good Hope Rd
Enola, PA 17025-1210
Phone (717) 972-7919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170907002279 PA Part B Supplier - Clinic/Group Practice 8729351077 Receives reassigned benefits from 970 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Penn State HLTH Comm Med7 organizations share this tax ID, including this one
Part of
Penn State Health

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1800 Center St
Ste 1A110
Camp Hill, PA 17011
Phone (717) 775-5093

2221 Noll Dr
Ste 2000
Lancaster, PA 17603
Phone (717) 715-1001

6 W Newport Rd
Lititz, PA 17543
Phone (717) 581-5255

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 68

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 68

NPI Registry JSON

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

{
    "created_epoch": "1644710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785283200000",
    "number": "1255086831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 825972",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191825972",
            "telephone_number": "717-531-4859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 N 21ST ST",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170112204",
            "telephone_number": "717-972-7919",
            "fax_number": "717-763-2272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "413 Granite Run Dr",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176016809",
            "country_code": "US",
            "telephone_number": "717-560-4200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 Bernville Rd",
            "address_purpose": "LOCATION",
            "city": "Reading",
            "state": "PA",
            "postal_code": "196059453",
            "country_code": "US",
            "telephone_number": "610-378-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "810 Plaza Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176012762",
            "country_code": "US",
            "telephone_number": "717-431-2368",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Good Hope Rd",
            "address_purpose": "LOCATION",
            "city": "Enola",
            "state": "PA",
            "postal_code": "170251210",
            "country_code": "US",
            "telephone_number": "717-972-7919",
            "fax_number": "717-763-2272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PENN STATE HEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENN STATE HEALTH",
        "enumeration_date": "2022-02-13",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A",
        "authorized_official_last_name": "MOYER-SWINKO",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VP/CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "717-531-8477"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Hill, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.