NPIMap

Individual provider Active NPI

Beth Elaine Fissel, CRNP

  • Family Nurse Practitioner
  • Manchester, PA
National Provider Identifier
1427420116
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP015339 Issued in PA
Practice address
4050 N George Street Ext
Manchester, PA 17345-9347
Phone
(717) 356-4370
Fax
(717) 260-3316
NPI assigned
Oct 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP015339 PA Primary

Addresses

Primary practice location

4050 N George Street Ext
Manchester, PA 17345-9347

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 851-1405

Other practice location 1

2106 Harrisburg Pike Ste 200
Lancaster, PA 17601-2644
Phone (717) 393-1771 ext. 4616

Other identifiers 1

IdentifierTypeStateIssuer
103061325MedicaidPA

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
I20151123001035 PA Practitioner - Nurse Practitioner 3577863620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

4050 N George St Ext
Manchester, PA 17345-9347
Phone (717) 356-4370

Hospital & facility affiliations

  • Wellspan York Hospital Hospital, York, PA, CCN 390046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP015339PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince Jan 13, 2020 Accepting new patients
Wellspan Medical Group CurrentSince Jan 13, 2020 Accepting new patients

Locations

4050 N George Street Ext
Manchester, PA 17345
Phone (717) 356-4370

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

1600 S George St
York, PA 17403
Phone (717) 848-3615

Interoperability endpoints

  • Direct secure messaging: bfissel64101@wellspan.direct-ci.com

Organizations & group practices 11

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.

Hospital & facility affiliations 4

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": "1445385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1427420116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-851-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 N GEORGE STREET EXT",
            "city": "MANCHESTER",
            "state": "PA",
            "postal_code": "173459347",
            "telephone_number": "717-356-4370",
            "fax_number": "717-260-3316"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2106 Harrisburg Pike Ste 200",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176012644",
            "country_code": "US",
            "telephone_number": "717-393-1771 x4616",
            "fax_number": "717-393-2782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FISSEL",
        "first_name": "BETH",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-21",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP015339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103061325",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, PA

Sources for this page

Verify at the official NPI Registry.