NPIMap

Individual provider Active NPI

Jessica Marie Fittipaldi, PAC

  • Surgical Physician Assistant
  • Lancaster, PA
National Provider Identifier
1518996628
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
MA052551 Issued in PA
Practice address
2106 Harrisburg Pike
Suite 116
Lancaster, PA 17601-2644
Phone
(717) 393-1900
Fax
(888) 972-8301
NPI assigned
Jul 1, 2006
Last updated
Aug 19, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA052551 PA
Surgical Physician Assistant 363AS0400X MA052551 PA Primary

Addresses

Primary practice location

2106 Harrisburg Pike
Suite 116
Lancaster, PA 17601-2644

Mailing address

2106 Harrisburg Pike
Suite 116
Lancaster, PA 17601-2644
Phone (717) 393-1900

Other names 1

  • Jessica Marie Wanchalk Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060804000187 PA Practitioner - Physician Assistant 5193728483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lancaster General Medical GroupGroup PAC ID 0941103683, 590 clinicians

Practice addresses (Care Compare)

538 N Queen St
Suite 200
Lancaster, PA 17603-3027
Phone (717) 291-5863

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA052551PAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster General Medical Group CurrentSince May 1, 2023 Accepting new patients
Lancaster General Medical Group CurrentSince May 1, 2023 Accepting new patients
Lancaster General Medical Group CurrentSince May 1, 2023 Accepting new patients
Lancaster General Medical Group Past Accepting new patients

Locations

426 Cloverleaf Rd
Elizabethtown, PA 17022
Phone (717) 299-1301

2102 Harrisburg Pike
Lancaster, PA 17601
Phone (717) 544-3600

2106 Harrisburg Pike
Ste 116
Lancaster, PA 17601
Phone (717) 393-1900

2108 Harrisburg Pike
Ste 100
Lancaster, PA 17601
Phone (717) 290-3900

3045 Marietta Ave
Lancaster, PA 17601
Phone (717) 299-4644

538 N Queen St
Ste 200
Lancaster, PA 17603
Phone (717) 393-1900

690 Good Dr
Fl 2
Lancaster, PA 17601
Phone (717) 544-0700

1001 Cornerstone Dr
#B
Mount Joy, PA 17552
Phone (717) 653-2929

950 S Octorara Trl
Parkesburg, PA 19365
Phone (610) 857-6616

Interoperability endpoints

  • Direct secure messaging: jwanchalk11124@direct-lghealth.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1518996628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 HARRISBURG PIKE",
            "address_2": "SUITE 116",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176012644",
            "telephone_number": "717-393-1900",
            "fax_number": "888-972-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 HARRISBURG PIKE",
            "address_2": "SUITE 116",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176012644",
            "telephone_number": "717-393-1900",
            "fax_number": "888-972-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITTIPALDI",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-01",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA052551",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA052551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "WANCHALK",
            "middle_name": "MARIE",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.