Individual provider Active NPI

Amy Suzanne Wesoly, PA-C

  • Physician Assistant
  • Harrisburg, PA
National Provider Identifier
1396081907
Registry record updated Jan 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA055944 Issued in PA
Practice address
4300 Londonderry Rd
Harrisburg, PA 17109-5317
Phone
(717) 231-8772
Fax
(717) 231-8435
NPI assigned
Dec 31, 2012
Last updated
Jan 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA055944 PA Primary

Addresses

Primary practice location

4300 Londonderry Rd
Harrisburg, PA 17109-5317

Mailing address

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

Other practice location 1

111 S Front St
Harrisburg, PA 17101-2010
Phone (717) 231-8772

Other identifiers 1

IdentifierTypeStateIssuer
103145793MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address awesoly10073@phsdirect.pinnaclehealth.org

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
I20130305000467 PA Practitioner - Physician Assistant 1254586837 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Health Hospitalist Services LLCGroup PAC ID 9739313545, 180 clinicians

Practice addresses (Care Compare)

111 S Front St
Harrisburg, PA 17101-2010
Phone (717) 231-8772

1995 Technology Pkwy
Mechanicsburg, PA 17050-8522
Phone (717) 231-8772

409 S 2ND St
Harrisburg, PA 17104-1612

4300 Londonderry Rd
Harrisburg, PA 17109-5317
Phone (717) 657-7332

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.15 of 100Reported as group
Quality
88.49
Promoting interoperability
100
Improvement activities
40
Cost
72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA055944PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services CurrentSince Feb 19, 2013 Accepting new patients
Pinnacle Health Medical Services CurrentSince Feb 19, 2013 Accepting new patients

Locations

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

111 S Front St
Harrisburg, PA 17101
Phone (717) 782-3282

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

4300 Londonderry Rd
Lower Paxton, PA 17109
Phone (717) 597-7044

Interoperability endpoints

  • Direct secure messaging: awesoly307404@upmc.direct-ci.com

Organizations & group practices 4

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": "1356912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611360000000",
    "number": "1396081907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S 2ND ST",
            "address_2": "SUITE 2F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 LONDONDERRY RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171095317",
            "telephone_number": "717-231-8772",
            "fax_number": "717-231-8435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 S Front St",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171012010",
            "country_code": "US",
            "telephone_number": "717-231-8772",
            "fax_number": "717-231-8435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WESOLY",
        "first_name": "AMY",
        "middle_name": "SUZANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-31",
        "last_updated": "2021-01-23",
        "certification_date": "2021-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA055944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103145793",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awesoly10073@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "111 S Front St",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171012010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.