Individual provider Active NPI

Olivia Elizabeth Gentilezza, PA-C

  • Physician Assistant
  • Scranton, PA
National Provider Identifier
1407428808
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA062610 Issued in PA
Practice address
449 Scranton Carbondale Hwy
Scranton, PA 18508-1115
Phone
(570) 344-6000
NPI assigned
Jul 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 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 MA062610 PA Primary

Addresses

Primary practice location

449 Scranton Carbondale Hwy
Scranton, PA 18508-1115

Mailing address

PO Box 701
Waverly, PA 18471-0701
Phone (570) 687-6710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211004001581 PA Practitioner - Physician Assistant 0345648432 Reassigns benefits to 3 organizations
I20231201001074 NY Practitioner - Physician Assistant 0345648432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

Practice addresses (Care Compare)

103 W Dominick St
Suite 10
Rome, NY 13440-5809
Phone (315) 271-2394

1233 Arsenal St
Watertown, NY 13601-2213
Phone (315) 221-5289

1425 Route 300
Newburgh, NY 12550-2908
Phone (845) 674-9735

1438 Western Ave
Albany, NY 12203-3421
Phone (518) 649-9986

18 Courtney Dr
Fairport, NY 14450-3338
Phone (585) 421-7537

26 Bolivar Dr
Bradford, PA 16701-3125
Phone (814) 817-4690

271 Grant Ave
Suite 100
Auburn, NY 13021-1407
Phone (315) 704-6097

3800 W Genesee St
Syracuse, NY 13219-1928
Phone (315) 552-9080

446 Fairview Ave
Suite 200
Hudson, NY 12534-1048
Phone (518) 267-3496

474 Route 3
Plattsburgh, NY 12901-6538
Phone (518) 536-3071

6227 Thompson Rd
Syracuse, NY 13206-1405
Phone (315) 937-2007

6870 E Genesee St
Fayetteville, NY 13066-1031
Phone (315) 679-4367

7375 Oswego Rd
Suite 1
Liverpool, NY 13090-3717
Phone (315) 291-0064

830 County Rd
Suite 64
Elmira, NY 14903-9719
Phone (607) 846-2030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
030922NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Jul 17, 2023 Accepting new patients
Geisinger-HM Joint Venture, LLC Physician Assistant CurrentSince Jul 17, 2023 Accepting new patients
Geisinger Clinic CurrentSince Jul 17, 2023 Accepting new patients
Geisinger-HM Joint Venture, LLC Physician Assistant CurrentSince Jul 17, 2023 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1407428808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 701",
            "city": "WAVERLY",
            "state": "PA",
            "postal_code": "184710701",
            "telephone_number": "570-687-6710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 SCRANTON CARBONDALE HWY",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185081115",
            "telephone_number": "570-344-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTILEZZA",
        "first_name": "OLIVIA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.