Individual provider Active NPI

Kasandra Ann Botti, D.O.

  • Emergency Medicine Physician
  • State College, PA
National Provider Identifier
1285652065
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS-010604-L Issued in PA
Practice address
155 Wellness Way
State College, PA 16803-6702
Phone
(814) 278-4851
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS-010604-L PA Primary

Addresses

Primary practice location

155 Wellness Way
State College, PA 16803-6702

Mailing address

155 Wellness Way
State College, PA 16803-6702
Phone (814) 278-4851

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110519000818 PA Practitioner - Emergency Medicine 3870779291 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS-010604-LPAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Nov 1, 2011 Accepting new patients
Geisinger Clinic Current Accepting new patients
Centre Emergency Medical Associates, PC. Emergency Medicine CurrentSince Apr 1, 2003 Accepting new patients
Geisinger Clinic CurrentSince Nov 1, 2011 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

155 Wellness Way
State College, PA 16803
Phone (800) 367-0179

Organizations & group practices 4

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1285652065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 WELLNESS WAY",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036702",
            "telephone_number": "814-278-4851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 WELLNESS WAY",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036702",
            "telephone_number": "814-278-4851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTI",
        "first_name": "KASANDRA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS-010604-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.