NPIMap

Individual provider Active NPI

Lisa E Ceraolo, MD

  • Internal Medicine Physician
  • Towanda, PA
National Provider Identifier
1326264383
Registry record updated Aug 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD431154 Issued in PA
Practice address
132 Colonial Dr
Towanda, PA 18848-8107
Phone
(570) 265-6165
Fax
(570) 265-3616
NPI assigned
Apr 18, 2007
Last updated
Aug 10, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD431154 PA Primary

Addresses

Primary practice location

132 Colonial Dr
Towanda, PA 18848-8107

Mailing address

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070627000114 PA Practitioner - Internal Medicine 8820197155 Reassigns benefits to 1 organization
I20171023000415 NY Practitioner - Internal Medicine 8820197155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Guthrie Medical Group PCGroup PAC ID 6002728656, shared by 5 NPIs, 795 clinicians

Practice addresses (Care Compare)

29 N Chemung St
Waverly, NY 14892-9611
Phone (607) 565-9975

412 S Main St
Multi Specialty
Athens, PA 18810-1618
Phone (570) 888-9655

Rte 6
Farm and Home Plaza
Wyalusing, PA 18853-0700
Phone (570) 746-3500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. CurrentSince Oct 1, 2017 Accepting new patients
Guthrie Medical Group, P.C. Internal Medicine CurrentSince Sep 1, 2015 Accepting new patients
Guthrie Medical Group, P.C. Current Accepting new patients
Guthrie Medical Group, P.C. Internal Medicine CurrentSince Sep 1, 2015 Accepting new patients
Guthrie Medical Group PC Past Accepting new patients

Locations

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

29 N Chemung St
Waverly, NY 14892
Phone (607) 565-9975

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

132 Colonial Dr
Towanda, PA 18848
Phone (570) 265-6165

91 Hospital Dr
Towanda, PA 18848
Phone (570) 268-2240

Interoperability endpoints

  • Direct secure messaging: cha.ceraolol@directaddress.net
  • Direct secure messaging: lceraolo58354@direct-guthrie.org

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 10

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": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439164800000",
    "number": "1326264383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 COLONIAL DR",
            "city": "TOWANDA",
            "state": "PA",
            "postal_code": "188488107",
            "telephone_number": "570-265-6165",
            "fax_number": "570-265-3616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERAOLO",
        "first_name": "LISA",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2015-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD431154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towanda, PA

Sources for this page

Verify at the official NPI Registry.