Individual provider Active NPI

Stephanie T. Packard, PA-C

  • Physician Assistant
  • Lancaster, PA
National Provider Identifier
1619029865
Registry record updated Sep 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA055322 Issued in PA
Practice address
555 North Duke St.
Lancaster, PA 17602
Phone
(717) 544-4978
Fax
(717) 544-7043
NPI assigned
Jan 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2015

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 C02760 MD
Medical Physician Assistant 363AM0700X MA055322 PA
Physician Assistant 363A00000X MA055322 PA Primary

Addresses

Primary practice location

555 North Duke St.
Lancaster, PA 17602

Mailing address

555 North Duke St.
Lancaster, PA 17602
Phone (717) 544-4978

Other identifiers 3

IdentifierTypeStateIssuer
P00138853OtherMDRAILROAD MED
2682762OtherPAHIGHMARK BLUE SHIELD-FREEDOM BLUE
1604209OtherPAGATEWAY MEDICARE ASSURED

Other names 1

  • Ms. Stephanie T. Singer Former name

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
I20120109000630 PA Practitioner - Physician Assistant 1456248830 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C02760MDMDPhysician Assistant
MA055322PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Reading Hospital CurrentSince Feb 1, 2021 Accepting new patients
Reading Hospital CurrentSince Feb 1, 2021 Accepting new patients
Wellspan Medical Group Past Accepting new patients
Medlantic Healthcare Group Past Accepting new patients

Locations

206 S 6th Ave
West Reading, PA 19611
Phone (484) 628-5437

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.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1619029865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 NORTH DUKE ST.",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "17602",
            "telephone_number": "717-544-4978",
            "fax_number": "717-544-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 NORTH DUKE ST.",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "17602",
            "telephone_number": "717-544-4978",
            "fax_number": "717-544-7043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKARD",
        "first_name": "STEPHANIE",
        "middle_name": "T.",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C02760",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA055322",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA055322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MED",
            "identifier": "P00138853",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD-FREEDOM BLUE",
            "identifier": "2682762",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY MEDICARE ASSURED",
            "identifier": "1604209",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "SINGER",
            "middle_name": "T.",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.