Individual provider Active NPI

Karlyle Genevieve Bistas, M.D.

  • Psychiatry Physician
  • Williamsport, PA
National Provider Identifier
1356917504
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD487908 Issued in PA
Practice address
1100 Grampian Blvd
Williamsport, PA 17701-1907
Phone
(570) 326-8723
NPI assigned
May 28, 2021
Last updated
Sep 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD487908 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

Other names 1

  • Mrs. Karlyle Genevieve Robinson Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address UPMCHospitals@upmc.com Health Information Exchange (HIE)

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
I20250820002622 PA Practitioner - Psychiatry 2668875097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Susquehanna Physician ServicesGroup PAC ID 2264336460, 611 clinicians

Practice addresses (Care Compare)

1100 Grampian Blvd
Williamsport, PA 17701-1907
Phone (570) 320-7525

700 High St
Williamsport, PA 17701-3198

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD487908PAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Susquehanna Physician Services CurrentSince Jul 1, 2025 Accepting new patients
Susquehanna Physician Services Psychiatry CurrentSince Jul 1, 2025 Accepting new patients

Locations

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

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

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

Organizations & group practices 2

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 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": "1622160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1356917504",
    "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"
        },
        {
            "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": "570-326-8723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISTAS",
        "first_name": "KARLYLE",
        "middle_name": "GENEVIEVE",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-28",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD487908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UPMCHospitals@upmc.com",
            "affiliation": "N",
            "endpointDescription": "Secure UPMC direct address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "600 Grant St Fl 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KARLYLE",
            "last_name": "ROBINSON",
            "middle_name": "GENEVIEVE",
            "prefix": "MRS.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Williamsport, PA

Sources for this page

Verify at the official NPI Registry.