Individual provider Active NPI

Heather Gersbacher Hazlett, RPA C

  • Medical Physician Assistant
  • York, PA
National Provider Identifier
1285700807
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA053963 Issued in PA
Practice address
25 Monument Rd
Suite 290
York, PA 17403-5060
Phone
(717) 812-4090
Fax
(717) 812-4092
NPI assigned
Nov 27, 2006
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 006869 NY
Physician Assistant 363A00000X MA053963 PA
Medical Physician Assistant 363AM0700X MA053963 PA Primary
Surgical Physician Assistant 363AS0400X MA053963 PA
Surgical Physician Assistant 363AS0400X 006869 NY

Addresses

Primary practice location

25 Monument Rd
Suite 290
York, PA 17403-5060

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 812-4090

Other practice location 1

25 Monument Rd Ste 200
York, PA 17403-5049
Phone (717) 812-4090

Other practice location 2

25 Monument Rd Ste 250
York, PA 17403-5060
Phone (717) 812-4090

Other practice location 3

2319 S George St
York, PA 17403-5009
Phone (717) 812-4090

Other practice location 4

1695 Roosevelt Ave Ste B
York, PA 17408-8521
Phone (717) 812-4090

Other identifiers 3

IdentifierTypeStateIssuer
02199948MedicaidNY
2130941OtherPAHIGHMARK BLUE SHIELD
1585197OtherPAGATEWAY-WMG

Other names 1

  • Heather Ann Gersbacher Former name

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
I20091015000106 PA Practitioner - Physician Assistant 2668553017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

1695 Roosevelt Ave
Suite B
York, PA 17408-8521
Phone (717) 851-5503

2319 S George St
Wellspan Orthopedics
York, PA 17403-5009
Phone (717) 812-4090

2339 S George St
York, PA 17403-5009

25 Monument Rd
York, PA 17403-5073

2618 E Market St
Autumn House
York, PA 17403
Phone (717) 845-7214

914 W Market St
Autumn House West
York, PA 17403
Phone (717) 845-7214

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6869NYMDPsychologist
MA053963PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Sep 21, 2009 Accepting new patients
Wellspan Medical Group CurrentSince Sep 21, 2009 Accepting new patients
Chenango Memorial Hospital, Inc. Physician Assistant Past Accepting new patients
Wellspan Medical Group Past Accepting new patients

Locations

1600 S George St
York, PA 17403
Phone (717) 848-3615

1803 Mount Rose Ave
Ste B3
York, PA 17403
Phone (717) 851-6816

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

25 Monument Rd
Ste 290
York, PA 17403
Phone (717) 741-8220

Interoperability endpoints

  • Direct secure messaging: hhazlett16200@wellspan.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1285700807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-812-4090",
            "fax_number": "717-741-3554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MONUMENT RD",
            "address_2": "SUITE 290",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174035060",
            "telephone_number": "717-812-4090",
            "fax_number": "717-812-4092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Monument Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174035049",
            "country_code": "US",
            "telephone_number": "717-812-4090",
            "fax_number": "717-741-3554",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 Monument Rd Ste 250",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174035060",
            "country_code": "US",
            "telephone_number": "717-812-4090",
            "fax_number": "717-812-4092",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2319 S George St",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174035009",
            "country_code": "US",
            "telephone_number": "717-812-4090",
            "fax_number": "717-741-3554",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1695 Roosevelt Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174088521",
            "country_code": "US",
            "telephone_number": "717-812-4090",
            "fax_number": "717-798-3687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAZLETT",
        "first_name": "HEATHER",
        "middle_name": "GERSBACHER",
        "name_prefix": "Mrs.",
        "credential": "RPA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "006869",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA053963",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA053963",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA053963",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "006869",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02199948",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "2130941",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY-WMG",
            "identifier": "1585197",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "GERSBACHER",
            "middle_name": "ANN",
            "credential": "RPA C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.