Individual provider Active NPI

Kelly Elizabeth Longenberger Warunek, PA-C

  • Physician Assistant
  • Danville, PA
National Provider Identifier
1598068355
Registry record updated Dec 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA056209 Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-1480
Phone
(570) 271-6389
Fax
(570) 271-6021
NPI assigned
Dec 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 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 OA003121 PA
Physician Assistant 363A00000X PA06933 TX
Physician Assistant 363A00000X MA056209 PA Primary

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-1480

Mailing address

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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address klongenberger119247@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
I20131206000200 PA Practitioner - Physician Assistant 3375722994 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

425 E 1St St
Bloomsburg, PA 17815-1480
Phone (570) 416-1816

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA056209PAMDPhysician Assistant
OA003121PAMDPhysician Assistant
PA06933TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Apr 6, 2015 Accepting new patients
Geisinger Clinic Physician Assistant CurrentSince Apr 6, 2015 Accepting new patients
Geisinger-HM Joint Venture, LLC Physician Assistant CurrentSince Mar 22, 2021 Accepting new patients
Geisinger-HM Joint Venture, LLC Physician Assistant CurrentSince Mar 22, 2021 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

549 Fair St
Bloomsburg, PA 17815
Phone (570) 387-2100

6850 Lows Rd
Bloomsburg, PA 17815
Phone (570) 784-6243

425 E 1st St
Bloomsburg, PA 17815
Phone (570) 387-2474

4203 Hospital Rd
Coal Township, PA 17866
Phone (570) 486-4588

100 N Academy Ave
Danville, PA 17822

68 Spring St
Lock Haven, PA 17745
Phone (570) 263-5830

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

255 Route 220 Hwy
Ste 209
Muncy, PA 17756

25 Church St
Wilkes Barre, PA 18702
Phone (570) 340-5800

Interoperability endpoints

  • Direct secure messaging: klongenberger119247@direct.geisinger.edu

Organizations & group practices 6

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": "1292371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608768000000",
    "number": "1598068355",
    "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": "178221480",
            "telephone_number": "570-271-6389",
            "fax_number": "570-271-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGENBERGER WARUNEK",
        "first_name": "KELLY",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-15",
        "last_updated": "2020-12-24",
        "certification_date": "2020-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA003121",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06933",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA056209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klongenberger119247@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 N Academy Ave",
            "city": "Danville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178221480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.