Individual provider Active NPI

Lynette E. Baber, PA-C

  • Physician Assistant
  • Danville, PA
National Provider Identifier
1497085526
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA054280 Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-5037
Phone
(570) 271-7149
Fax
(570) 271-7165
NPI assigned
Jan 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 003736 CT
Surgical Physician Assistant 363AS0400X 003736 CT
Physician Assistant 363A00000X MA054280 PA Primary

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-5037

Mailing address

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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ldorman85852@direct.geisinger.edu Direct

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
I20100215000310 PA Practitioner - Physician Assistant 1759425770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
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)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

1000 E Mountain Dr
Wilkes Barre, PA 18711-0027
Phone (570) 826-7300

950 E Mountain Blvd
Wilkes Barre, PA 18702-7924
Phone (570) 808-5770

Hospital & facility affiliations

  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
003736CTMDClinical Psychologist
MA054280PAMDPhysician Assistant
3736CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Feb 1, 2010 Accepting new patients
Geisinger Clinic CurrentSince Feb 1, 2010 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

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 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1497085526",
    "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",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178225037",
            "telephone_number": "570-271-7149",
            "fax_number": "570-271-7165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABER",
        "first_name": "LYNETTE",
        "middle_name": "E.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-13",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "003736",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "003736",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA054280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ldorman85852@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 N Academy Ave",
            "city": "Danville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178225037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.