Individual provider Active NPI

Joseph M Mucciolo Jr., MD

  • Surgery Physician
  • Lewisburg, PA
National Provider Identifier
1447228366
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD067194L Issued in PA
Practice address
25 Lystra Rogers Dr
Lewisburg, PA 17837-8807
Phone
(570) 523-3290
Fax
(570) 524-5231
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD067194L PA Primary

Addresses

Primary practice location

25 Lystra Rogers Dr
Lewisburg, PA 17837-8807

Mailing address

1 Hospital Dr
Suite 306
Lewisburg, PA 17837-9350
Phone (570) 522-4110

Other identifiers 1

IdentifierTypeStateIssuer
0018668060003MedicaidPA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040120000300 PA Practitioner - General Surgery 0941101182 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Georgetown University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians
Evangelical Medical Services OrganizationGroup PAC ID 9133033087, 255 clinicians

Practice addresses (Care Compare)

1 Hospital Dr
Lewisburg, PA 17837-9350
Phone (570) 522-4264

25 Lystra Rogers Dr
Lewisburg, PA 17837-8807
Phone (570) 523-3290

25 Monument Rd
York, PA 17403-5073

3 Hospital Dr
Lewisburg, PA 17837-9394

Hospital & facility affiliations

  • Wellspan Evangelical Community Hospital Hospital, Lewisburg, PA, CCN 390013

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy18
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Pacemaker insertion or repair1-10
Upper gastrointestinal (GI) endoscopy for acid reflux13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD067194LPAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Dec 1, 2025 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Evangelical Medical Services Organization CurrentSince Jan 1, 2012 Accepting new patients
Wellspan Medical Group CurrentSince Dec 1, 2025 Accepting new patients
Evangelical Medical Services Organization Surgery CurrentSince Jan 1, 2012 Accepting new patients
Geisinger Clinic Past Accepting new patients
Wellspan Medical Group Past Accepting new patients

Locations

25 Lystra Rogers Dr
Lewisburg, PA 17837
Phone (570) 523-3290

3 Hospital Dr
Ste 206
Lewisburg, PA 17837
Phone (570) 522-9771

1 Hospital Dr
Ste 306
Lewisburg, PA 17837
Phone (570) 522-4110

3 Hospital Dr
Ste 318
Lewisburg, PA 17837
Phone (570) 522-1007

1 Hospital Dr
Lewisburg, PA 17837
Phone (570) 522-2000

457 River Ave
Williamsport, PA 17701
Phone (570) 323-7246

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

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

Interoperability endpoints

  • Direct secure messaging: jmucciolo485291@wellspan.direct-ci.com

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 1

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1447228366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "address_2": "SUITE 306",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178379350",
            "telephone_number": "570-522-4110",
            "fax_number": "570-768-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 LYSTRA ROGERS DR",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178378807",
            "telephone_number": "570-523-3290",
            "fax_number": "570-524-5231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCCIOLO",
        "first_name": "JOSEPH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD067194L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018668060003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, PA

Sources for this page

Verify at the official NPI Registry.