Individual provider Active NPI

Joanne M Petro, PA C

  • Physician Assistant
  • Mountain Top, PA
National Provider Identifier
1265486195
Registry record updated Dec 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA000608L Issued in PA
Practice address
35 S Mountain Blvd
Mountain Top, PA 18707-1122
Phone
(570) 474-5847
Fax
(570) 474-6952
NPI assigned
May 22, 2006
Last updated
Dec 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OA002169 PA
Physician Assistant 363A00000X MA000608L PA Primary

Addresses

Primary practice location

35 S Mountain Blvd
Mountain Top, PA 18707-1122

Mailing address

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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jpetro78850@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
I20050105000163 PA Practitioner - Physician Assistant 1456309699 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1983
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

35 S Mountain Blvd
Mountain Top, PA 18707-1122
Phone (570) 474-5847

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA000608LPAMDPhysician Assistant
OA002169PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger-HM Joint Venture, LLC Physician Assistant CurrentSince Mar 22, 2021 Accepting new patients
Geisinger Clinic Physician Assistant CurrentSince Oct 1, 2013 Accepting new patients
Geisinger-HM Joint Venture, LLC Physician Assistant CurrentSince Mar 22, 2021 Accepting new patients
Geisinger Clinic CurrentSince Oct 1, 2013 Accepting new patients
Geisinger Clinic Past Accepting new patients
Intermountain Medical Group, Inc Past Accepting new patients

Locations

226 Buckaroo Ln
Bellefonte, PA 16823
Phone (814) 353-1030

100 N Academy Ave
Danville, PA 17822

175 Northumberland St
Danville, PA 17821
Phone (570) 284-4575

68 Spring St
Lock Haven, PA 17745
Phone (570) 263-5830

955 Bellefonte Ave
Lock Haven, PA 17745
Phone (570) 748-7714

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

229 S Mountain Blvd
Mountain Top, PA 18707
Phone (570) 474-5958

12 Kirby Ave
Mountain Top, PA 18707
Phone (570) 474-5978

128 E Main St
Nanticoke, PA 18634
Phone (570) 258-1304

1020 Northern Blvd
South Abington Township, PA 18411
Phone (570) 587-2290

175 S Wilkes Barre Blvd
Wilkes Barre, PA 18702
Phone (570) 821-0808

35 S Mountain Blvd
Wilkes Barre, PA 18707
Phone (570) 474-5072

Interoperability endpoints

  • Direct secure messaging: jpetro78850@direct.geisinger.edu

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1265486195",
    "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": "35 S MOUNTAIN BLVD",
            "city": "MOUNTAIN TOP",
            "state": "PA",
            "postal_code": "187071122",
            "telephone_number": "570-474-5847",
            "fax_number": "570-474-6952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRO",
        "first_name": "JOANNE",
        "middle_name": "M",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA002169",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA000608L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpetro78850@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "35 S Mountain Blvd",
            "city": "Mountain Top",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187071122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mountain Top, PA

Sources for this page

Verify at the official NPI Registry.