NPIMap

Organization Active NPI

Penn State Health Medical Group, LLC

  • Pediatrics Physician
  • West Reading, PA
National Provider Identifier
1609347152
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PENN STATE HEALTH MEDICAL GROUP, LLC
Practice address
655 Walnut St
West Reading, PA 19611-1242
Phone
(610) 372-9222
Fax
(610) 372-0232
NPI assigned
Dec 10, 2018
Last updated
Feb 3, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
PENN STATE HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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

Authorized official

Name
Tracy L Moyer-Swinko
Title
VP, Chief Financial Officer
Phone
(717) 531-8477

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

655 Walnut St
West Reading, PA 19611-1242

Mailing address

PO Box 825972
Philadelphia, PA 19182-5972
Phone (717) 531-4859

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170907002279 PA Part B Supplier - Clinic/Group Practice 8729351077 Receives reassigned benefits from 970 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Part of
Penn State Health

Locations

431 N 21st St
#100
Camp Hill, PA 17011
Phone (717) 763-3730

51 Business Campus Way
Ste 200
Duncannon, PA 17020
Phone (717) 834-3108

26 Springs Ave
Ste E
Gettysburg, PA 17325

211 Broad St
Marysville, PA 17053
Phone (717) 957-3500

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 69

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 69

NPI Registry JSON

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770076800000",
    "number": "1609347152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 825972",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191825972",
            "telephone_number": "717-531-4859",
            "fax_number": "717-312-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 WALNUT ST",
            "city": "WEST READING",
            "state": "PA",
            "postal_code": "196111242",
            "telephone_number": "610-372-9222",
            "fax_number": "610-372-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENN STATE HEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENN STATE HEALTH",
        "enumeration_date": "2018-12-10",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A",
        "authorized_official_last_name": "MOYER-SWINKO",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VP, CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "717-531-8477"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Reading, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.