NPIMap

Individual provider Active NPI

Elizabeth Klucka

  • Family Medicine Physician
  • Montoursville, PA
National Provider Identifier
1366705808
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS016756 Issued in PA
Practice address
900 Plaza Dr
Montoursville, PA 17754-2448
Phone
(570) 601-8574
NPI assigned
Jun 20, 2012
Last updated
May 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS016756 PA Primary

Addresses

Primary practice location

900 Plaza Dr
Montoursville, PA 17754-2448

Mailing address

1201 Grampian Blvd
Williamsport, PA 17701-1900

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address elizabeth.m.klucka@upmcdirect.com UPMC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150901001227 PA Practitioner - Family PracticePractitioner - Geriatric Medicine 1951547280 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Philadelphia College of Osteopathic Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Susquehanna Physician ServicesGroup PAC ID 2264336460, shared by 32 NPIs, 611 clinicians
H2 Rehabilitation Extension Services LLCGroup PAC ID 6406131622, shared by 5 NPIs, 161 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

175 Pine St
Suite 200
Williamsport, PA 17701-6549
Phone (570) 326-2447

1948 E 3Rd St
Suite C
Williamsport, PA 17701-3945
Phone (570) 327-1760

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

740 High St
Suite 4001
Williamsport, PA 17701-3111
Phone (570) 321-2345

Hospital & facility affiliations

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS016756PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Susquehanna Physician Services Family Medicine CurrentSince Aug 17, 2015 Accepting new patients
Susquehanna Physician Services Family Medicine CurrentSince Nov 13, 2023 Accepting new patients
Susquehanna Physician Services Family Medicine CurrentSince Jul 1, 2024 Accepting new patients

Locations

900 Plaza Dr
Montoursville, PA 17754
Phone (570) 368-3321

10 Shady Ln
Ste 101
Muncy, PA 17756
Phone (570) 546-4059

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

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

175 Pine St
Ste 200
Williamsport, PA 17701
Phone (570) 326-2447

700 High St
Williamsport, PA 17701
Phone (570) 321-2000

740 High St
Ste 4001
Williamsport, PA 17701
Phone (570) 321-2345

Interoperability endpoints

  • Direct secure messaging: eklucka140322@upmc.direct-ci.com
  • Direct secure messaging: elizabeth.m.klucka@upmcdirect.com

Organizations & group practices 3

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 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1366705808",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PLAZA DR",
            "city": "MONTOURSVILLE",
            "state": "PA",
            "postal_code": "177542448",
            "telephone_number": "570-601-8574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUCKA",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS016756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elizabeth.m.klucka@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "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 Montoursville, PA

Sources for this page

Verify at the official NPI Registry.