Individual provider Active NPI

Dana Corrine Poleto, CRNP

  • Gerontology Nurse Practitioner
  • Williamsport, PA
National Provider Identifier
1467163345
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SPS26700 Issued in PA
Practice address
700 High Street
Williamsport, PA 17701-3198
Phone
(570) 321-3580
NPI assigned
Dec 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X SPS26700 PA Primary

Addresses

Primary practice location

700 High Street
Williamsport, PA 17701-3198

Mailing address

1201 Grampian Blvd
Williamsport, PA 17701-1900
Phone (888) 647-9600

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
I20230103001034 PA Practitioner - Nurse Practitioner 9830569144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Susquehanna Physician ServicesGroup PAC ID 2264336460, 611 clinicians

Practice addresses (Care Compare)

700 High St
Williamsport, PA 17701-3100
Phone (570) 321-3580

Hospital & facility affiliations

  • Upmc Williamsport Hospital, Williamsport, PA, CCN 390045

Merit-based Incentive Payment System (MIPS)

Final score
81.06 of 100Reported as group
Quality
62.07
Promoting interoperability
100
Improvement activities
40
Cost
74.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SPS26700PAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Susquehanna Physician Services CurrentSince Dec 18, 2022 Accepting new patients
Susquehanna Physician Services CurrentSince Dec 18, 2022 Accepting new patients
Susquehanna Physician Services Past Accepting new patients

Locations

1100 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8005

1201 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8723

700 High St
Williamsport, PA 17701
Phone (570) 321-1000

Interoperability endpoints

  • Direct secure messaging: dpoleto201608@upmc.direct-ci.com
  • Direct secure messaging: dana.c.poleto@upmcdirect.com

Organizations & group practices 3

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 7

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": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1467163345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900",
            "telephone_number": "888-647-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 HIGH STREET",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177013198",
            "telephone_number": "570-321-3580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLETO",
        "first_name": "DANA",
        "middle_name": "CORRINE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SPS26700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

Verify at the official NPI Registry.