NPIMap

Organization Active NPI

Pinnacle Health Regional Physicians

Doing business as Memorial Family Medicine at Susquehanna Trail

  • Family Medicine Physician
  • York, PA
National Provider Identifier
1386164556
Registry record updated Jun 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PINNACLE HEALTH REGIONAL PHYSICIANS
Doing business as
Memorial Family Medicine at Susquehanna Trail
Practice address
2295 N Susquehanna TRL Ste a
York, PA 17404-8495
Phone
(717) 812-0731
Fax
(717) 812-9848
NPI assigned
Jun 20, 2017
Last updated
Jun 20, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2017

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

Authorized official

Name
Christopher P. Markley
Title
Sr VP, Strat SVCS/Gen Counsel
Phone
(717) 231-8210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

2295 N Susquehanna TRL Ste a
York, PA 17404-8495

Mailing address

409 S 2ND St Ste 2F
Harrisburg, PA 17104-1612

Other names 1

  • Memorial Family Medicine at Susquehanna Trail Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170810001731 PA Part B Supplier - Clinic/Group Practice 7416228358 Receives reassigned benefits from 514 practitioners
This NPI is an additional NPI on the enrollment

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0986081Memorial Family Medicine at Susquehanna Trail2295A Susquehanna Trail, Ste a, York, PA 17404Certificate of waiverMar 26, 2028

National Provider Directory

National Provider Directory
Tax ID family
Pinnacle Health Regional Physicians68 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1533 Commerce Ave
Ste 2
Carlisle, PA 17015
Phone (717) 796-9300

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497916800000",
    "number": "1386164556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S 2ND ST STE 2F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2295 N SUSQUEHANNA TRL STE A",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174048495",
            "telephone_number": "717-812-0731",
            "fax_number": "717-812-9848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE HEALTH REGIONAL PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-20",
        "last_updated": "2017-06-20",
        "status": "A",
        "authorized_official_last_name": "MARKLEY",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "SR VP, STRAT SVCS/GEN COUNSEL",
        "authorized_official_telephone_number": "717-231-8210"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Family Medicine at Susquehanna Trail",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memorial Family Medicine at Susquehanna Trail",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in York, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.