Individual provider Active NPI

Molly Zielen, PA-C

  • Medical Physician Assistant
  • Camp Hill, PA
National Provider Identifier
1255700845
Registry record updated Dec 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA058095 Issued in PA
Practice address
890 Poplar Church Rd
Suite 508
Camp Hill, PA 17011-2250
Phone
(717) 761-3875
Fax
(717) 761-7893
NPI assigned
Sep 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2018

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 MA058095 PA
Medical Physician Assistant 363AM0700X MA058095 PA Primary

Addresses

Primary practice location

890 Poplar Church Rd
Suite 508
Camp Hill, PA 17011-2250

Mailing address

890 Poplar Church Rd
Suite 508
Camp Hill, PA 17011-2250
Phone (717) 761-3875

Other identifiers 1

IdentifierTypeStateIssuer
MA058095OtherPASTATE MEDICAL LICENSE

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
I20160404000863 PA Practitioner - Physician Assistant 9335449149

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA058095PAMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544572800000",
    "number": "1255700845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 POPLAR CHURCH RD",
            "address_2": "SUITE 508",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170112250",
            "telephone_number": "717-761-3875",
            "fax_number": "717-761-7893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 POPLAR CHURCH RD",
            "address_2": "SUITE 508",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170112250",
            "telephone_number": "717-761-3875",
            "fax_number": "717-761-7893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIELEN",
        "first_name": "MOLLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-24",
        "last_updated": "2018-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA058095",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA058095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "MA058095",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Hill, PA

Sources for this page

Verify at the official NPI Registry.