Madysen Kacey Lussi
Individual provider Active NPI Physician Assistant · Wilkes Barre, PA
NPI 1306313069 · NPPES record last updated Jan 7, 2022
Key facts
- NPI
- 1306313069
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 1155 E Mountain Blvd
Wilkes Barre, PA 18702-7906 - Phone
- (570) 808-7916
- Fax
- (570) 808-6006
- NPI assigned
- Oct 30, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 20
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Geisinger Clinic
Practice addresses (Care Compare)
100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144
1000 E Mountain Dr
Wilkes Barre, PA 18711-0027
Phone (570) 826-7300
950 E Mountain Blvd
Wilkes Barre, PA 18702-7924
Phone (570) 808-5770
Hospital & facility affiliations
- Geisinger Wyoming Valley Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190110000417 | PA | Practitioner - Physician Assistant | 3173869245 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Geisinger Clinic | Current |
Accepting new patients | |
| Geisinger Clinic | Current |
Accepting new patients | |
| Geisinger Clinic | Past | Accepting new patients |
Locations
100 N Academy Ave
Danville, PA 17822
521 Mt Pleasant Dr
Scranton, PA 18503
Phone (570) 342-8500
1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300
675 Baltimore Dr
Wilkes Barre, PA 18702
Phone (570) 808-5757
950 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 808-3290
Interoperability endpoints
- mjones173051@direct.geisinger.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA | Yes |
Addresses
Primary practice location
1155 E Mountain Blvd
Wilkes Barre, PA 18702-7906
Mailing address
100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mjones173051@direct.geisinger.edu | Direct |
Other providers in Wilkes Barre, PA
- Margaret Mary Lukaszewski
- Joan M Luksa
- Anne T Lunney
- Jocelyn A Lunney
- Karen J Lurito
- Colleen Ann Lutchko
- Shane Lutchman
- Jennifer Lutsey
- Julie Ann Lutsky
- Dana Lutz
All providers in Wilkes Barre, PA · Physician Assistant in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.