Individual provider Active NPI

Melissa Laidacker

  • Women's Health Nurse Practitioner
  • Harrisburg, PA
National Provider Identifier
1609249432
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
SP015234 Issued in PA
Practice address
4700 Union Deposit Rd Ste 140
Harrisburg, PA 17111-3774
Phone
(717) 652-6605
Fax
(717) 652-6431
NPI assigned
Nov 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X SP015234 PA Primary

Addresses

Primary practice location

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

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 812-2316

Other identifiers 1

IdentifierTypeStateIssuer
PO1676466OtherPARAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlaidacker172878@phsdirect.pinnaclehealth.org

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
I20160127002667 PA Practitioner - Nurse Practitioner 6103129929 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Health Medical ServicesGroup PAC ID 7618960493, 1,025 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP015234PAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services CurrentSince May 1, 2020 Accepting new patients
Pinnacle Health Medical Services Current Accepting new patients
Pinnacle Health Medical Services CurrentSince May 1, 2020 Accepting new patients
Wellspan Medical Group CurrentSince Nov 28, 2015 Accepting new patients
Wellspan Medical Group CurrentSince Nov 28, 2015 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Pinnacle Health Medical Services Past Accepting new patients

Locations

4310 Londonderry Rd
Ste 101
Harrisburg, PA 17109
Phone (717) 724-0720

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
Phone (717) 728-1700

2025 Technology Pkwy
Ste 309
Mechanicsburg, PA 17050

5210 E Trindle Rd
Mechanicsburg, PA 17050
Phone (717) 218-6670

300 Bretz Ct
Newport, PA 17074
Phone (717) 567-3174

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

2050 S Queen St
#200
York, PA 17403
Phone (717) 812-2316

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

Interoperability endpoints

  • Direct secure messaging: mlaidacker293738@upmc.direct-ci.com

Organizations & group practices 7

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 9

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": "1446422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1609249432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-812-2316",
            "fax_number": "717-848-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 UNION DEPOSIT RD STE 140",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171113774",
            "telephone_number": "717-652-6605",
            "fax_number": "717-652-6431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIDACKER",
        "first_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-02",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "PA",
            "license": "SP015234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "PO1676466",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlaidacker172878@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "4700 Union Deposit Rd Ste 140",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171113774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.