Wellspan Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WELLSPAN MEDICAL GROUP

Doing business as

WellSpan Family Medicine - Wheatlyn

Practice address

235 Rosedale Dr
Manchester, PA 17345-1022

Phone

(717) 812-5229

Fax

(717) 266-7453

NPI assigned

Dec 1, 2006

Last updated

Sep 11, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Tina Vest

Title

Credentialing Supervisor

Phone

(717) 851-6928

Specialties & licenses 2

Addresses

Other identifiers 12

Other names 1

• WellSpan Family Medicine - Wheatlyn Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 16

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.

• Jonathan D Bastian, PA-C

  • Physician Assistant
  • Lewisburg, PA
  • NPI 1346616406
  NPD
• Casey Lynn Seitz Berrettini, PA-C

  • Medical Physician Assistant
  • Lititz, PA
  • NPI 1518426139
  NPD
• Ryan M Decort, DO

  • Internal Medicine Physician
  • Chambersburg, PA
  • NPI 1043531551
  NPD
• Nicholas Joseph Delbuono, DO

  • Emergency Medicine Physician
  • Lewisburg, PA
  • NPI 1316525850
  NPD
• Renee Marie Fluman, PA-C

  • Physician Assistant
  • Mifflinburg, PA
  • NPI 1093701112
  NPD
• Sarah Elizabeth Hinkle, CRNP

  • Critical Care Neonatal Nurse Practitioner
  • York, PA
  • NPI 1952297525
  NPD
• Amit Khan, DO

  • Internal Medicine Physician
  • Lebanon, PA
  • NPI 1083349369
  NPD
• Jennifer Lynn Kissane, M.D.

  • Vascular & Interventional Radiology Physician
  • Lebanon, PA
  • NPI 1164700225
  NPD
• Rise Perry, CRNP

  • Gerontology Nurse Practitioner
  • Lancaster, PA
  • NPI 1588076434
  NPD
• John M Pfeifer, M.D.

  • Cardiovascular Disease Physician
  • Danville, PA
  • NPI 1104845395
  NPD
• Geraldine Policard, MD

  • Hospitalist Physician
  • Chambersburg, PA
  • NPI 1619225703
  NPD
• Jenna Lynne Rogers, APRN-FNP

  • Family Nurse Practitioner
  • York, PA
  • NPI 1235806787
  NPD

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536624000000",
    "number": "1437227055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 MOUNT ROSE AVE",
            "address_2": "SUITE B3",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174033051",
            "telephone_number": "717-851-1405",
            "fax_number": "717-266-7453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 ROSEDALE DR",
            "city": "MANCHESTER",
            "state": "PA",
            "postal_code": "173451022",
            "telephone_number": "717-812-5229",
            "fax_number": "717-266-7453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPAN MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2018-09-11",
        "status": "A",
        "authorized_official_last_name": "VEST",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "717-851-6928",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "82198",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA3246",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "S1E4",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "03058800",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN HOPKINS",
            "identifier": "800174",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH 65 PA",
            "identifier": "0083498001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1519817",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD BCBS",
            "identifier": "KX10",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY",
            "identifier": "1142444",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "142576",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5525074",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007721360087",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellSpan Family Medicine - Wheatlyn",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeremy Scott Timothy, MD
• Nisha Tripathee, CRNP
• Randall Dean Ward, RPH
• Amber Weirich
• Christine Mary Weld, O.D.
• Wellspan Medical Group (WellSpan Urgent Care)
• Wheatlyn Dental Practice, LLP
• Azeb Legesse Worku
• Benjamin Joseph Wortman
• Tangina Zeak, RN

• Family Medicine Physician in Manchester, PA
• Providers in Manchester, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.