Individual provider Active NPI

Kyle Creighton Thiel, CRNP, ACNP

  • Nurse Practitioner
  • Williamsport, PA
National Provider Identifier
1346862745
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP021841 Issued in PA
Practice address
1100 Grampian Blvd
Williamsport, PA 17701-1907
Phone
(570) 326-8053
Fax
(570) 326-8638
NPI assigned
May 8, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP021841 PA Primary

Addresses

Primary practice location

1100 Grampian Blvd
Williamsport, PA 17701-1907

Mailing address

1201 Grampian Blvd
Williamsport, PA 17701-1900
Phone (570) 326-8723

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kthiel249868@upmc.direct-ci.com

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
I20200603000338 PA Practitioner - Nurse Practitioner 9436570207 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Susquehanna Physician ServicesGroup PAC ID 2264336460, shared by 32 NPIs, 611 clinicians

Practice addresses (Care Compare)

1201 Grampian Blvd
Suite 1a
Williamsport, PA 17701-1965
Phone (570) 326-8080

700 High St
Williamsport, PA 17701-3100

Hospital & facility affiliations

  • Upmc Williamsport Hospital, Williamsport, PA, CCN 390045

Merit-based Incentive Payment System (MIPS)

Final score
81.06 of 100Reported as group
Quality
62.07
Promoting interoperability
100
Improvement activities
40
Cost
74.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP021841PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Susquehanna Physician Services Nurse Practitioner CurrentSince Apr 30, 2023 Accepting new patients
Susquehanna Physician Services CurrentSince Aug 24, 2022 Accepting new patients
Susquehanna Physician Services CurrentSince Jun 1, 2020 Accepting new patients
Susquehanna Physician Services Nurse Practitioner CurrentSince Jun 1, 2020 Accepting new patients
Sunbury Clinic Company LLC Current Accepting new patients

Locations

330 N 12th St
Ste A
Sunbury, PA 17801
Phone (570) 286-0303

1201 Grampian Blvd
Ste 1A
Williamsport, PA 17701
Phone (570) 326-8080

700 High St
Williamsport, PA 17701
Phone (570) 321-1000

1100 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8005

1201 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8723

Interoperability endpoints

  • Direct secure messaging: kthiel249868@upmc.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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1588896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1346862745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900",
            "telephone_number": "570-326-8723",
            "fax_number": "570-326-8922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011907",
            "telephone_number": "570-326-8053",
            "fax_number": "570-326-8638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIEL",
        "first_name": "KYLE",
        "middle_name": "CREIGHTON",
        "credential": "CRNP, ACNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-08",
        "last_updated": "2025-12-05",
        "certification_date": "2020-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP021841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kthiel249868@upmc.direct-ci.com",
            "affiliation": "N",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

Verify at the official NPI Registry.