Individual provider Active NPI

Krista Rebo-Massara, DO

  • Obstetrics & Gynecology Physician
  • Harrisburg, PA
National Provider Identifier
1487682803
Registry record updated Jul 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
OS009880L Issued in PA
Practice address
4700 Union Deposit Rd
Suite 140
Harrisburg, PA 17111-3774
Phone
(717) 652-6605
Fax
(717) 671-0794
NPI assigned
Jun 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X OS009880L PA Primary

Addresses

Primary practice location

4700 Union Deposit Rd
Suite 140
Harrisburg, PA 17111-3774

Mailing address

4700 Union Deposit Rd
Suite 140
Harrisburg, PA 17111-3774
Phone (717) 652-6605

Other identifiers 1

IdentifierTypeStateIssuer
001811933MedicaidPA

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
I20071025000110 PA Practitioner - Obstetrics/Gynecology 8426145392 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS009880LPAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services CurrentSince May 1, 2020 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince Jun 14, 2024 Accepting new patients
Wellspan Medical Group CurrentSince Jun 14, 2024 Accepting new patients
Pinnacle Health Medical Services Obstetrics & Gynecology Current Accepting new patients
Pinnacle Health Medical Services CurrentSince May 1, 2020 Accepting new patients
The Gettysburg Hospital Past Accepting new patients
Family Health Associates of Geisinger Lewistown Hospital Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

147 Gettys St
Gettysburg, PA 17325
Phone (717) 334-2121

4700 Union Deposit Rd
Ste 140
Harrisburg, PA 17111
Phone (717) 540-5694

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

2025 Technology Pkwy
Ste 309
Mechanicsburg, PA 17050

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: krebomassara357536@wellspan.direct-ci.com

Organizations & group practices 8

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310083200000",
    "number": "1487682803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 UNION DEPOSIT RD",
            "address_2": "SUITE 140",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171113774",
            "telephone_number": "717-652-6605",
            "fax_number": "717-671-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 UNION DEPOSIT RD",
            "address_2": "SUITE 140",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171113774",
            "telephone_number": "717-652-6605",
            "fax_number": "717-671-0794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBO-MASSARA",
        "first_name": "KRISTA",
        "name_prefix": "Mrs.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2011-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "OS009880L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001811933",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.