Individual provider Active NPI

Alexandria Lee Shaffer, CRNP

  • Nurse Practitioner
  • Bloomsburg, PA
National Provider Identifier
1437758356
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP022135 Issued in PA
Practice address
425 E 1St St
Bloomsburg, PA 17815-1480
Phone
(570) 416-1890
NPI assigned
Oct 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP022135 PA
Nurse Practitioner 363L00000X SP022135 PA Primary

Addresses

Primary practice location

425 E 1St St
Bloomsburg, PA 17815-1480

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

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
I20210908001472 PA Practitioner - Nurse Practitioner 6002212644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

128 E Main St
Nanticoke, PA 18634-1604
Phone (570) 258-1304

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP022135PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Nurse Practitioner CurrentSince Sep 13, 2021 Accepting new patients
Geisinger Clinic Nurse Practitioner Current Accepting new patients
Geisinger Clinic CurrentSince Sep 13, 2021 Accepting new patients
Wilkes Barre Treatment LLC Past Accepting new patients
Geisinger-HM Joint Venture, LLC Nurse Practitioner Past Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

65 Briar Creek Plz
Berwick, PA 18603
Phone (570) 802-5590

425 E 1st St
Bloomsburg, PA 17815
Phone (570) 387-2474

240 Mall Blvd
Bloomsburg, PA 17815
Phone (570) 416-5435

114 Lt Michael Cleary Dr
Dallas, PA 18612
Phone (570) 255-1178

100 N Academy Ave
Danville, PA 17822

175 Northumberland St
Danville, PA 17821
Phone (570) 284-4575

499 Wyoming Ave
Kingston, PA 18704
Phone (570) 283-2161

560 Pierce St
Kingston, PA 18704
Phone (570) 283-2161

128 E Main St
Nanticoke, PA 18634
Phone (570) 258-1304

529 Terry Reiley Way
Pottsville, PA 17901
Phone (570) 624-4120

1201 Keystone Blvd
Pottsville, PA 17901
Phone (570) 374-2657

1151 N 4th St
Sunbury, PA 17801
Phone (570) 286-6773

35 S Mountain Blvd
Wilkes Barre, PA 18707
Phone (570) 474-5072

1824 E 3rd St
Williamsport, PA 17701
Phone (570) 322-4422

Interoperability endpoints

  • Direct secure messaging: ashaffer467329@direct.geisinger.edu

Organizations & group practices 6

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": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1437758356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E 1ST ST",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178151480",
            "telephone_number": "570-416-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "ALEXANDRIA",
        "middle_name": "LEE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP022135",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP022135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomsburg, PA

Sources for this page

Verify at the official NPI Registry.