Individual provider Active NPI

Caitlin Mary Ellyn Mammolenti, MD

  • Anesthesiology Physician
  • York, PA
National Provider Identifier
1619505674
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD485378 Issued in PA
Practice address
1001 S George St
York, PA 17403-3676
Phone
(717) 812-7687
Fax
(717) 851-5250
NPI assigned
Mar 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD485378 PA Primary

Addresses

Primary practice location

1001 S George St
York, PA 17403-3676

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 851-1405

Other practice location 1

25 Monument Rd Ste 270
York, PA 17403-5073
Phone (717) 741-8250

Other practice location 2

55 Monument Rd
York, PA 17403-5023
Phone (717) 812-6425

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240819000902 PA Practitioner - Anesthesiology 1052735578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

1001 S George St
York, PA 17403-3676
Phone (717) 851-2345

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince Sep 9, 2024 Accepting new patients
Wellspan Medical Group CurrentSince Sep 9, 2024 Accepting new patients

Locations

1001 S George St
York, PA 17403
Phone (717) 812-7687

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

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

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

55 Monument Rd
York, PA 17403
Phone (717) 741-5257

Interoperability endpoints

  • Direct secure messaging: cmammolenti438482@wellspan.direct-ci.com

Organizations & group practices 3

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 4

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": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1619505674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405",
            "fax_number": "717-851-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S GEORGE ST",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174033676",
            "telephone_number": "717-812-7687",
            "fax_number": "717-851-5250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Monument Rd Ste 270",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174035073",
            "country_code": "US",
            "telephone_number": "717-741-8250",
            "fax_number": "717-741-8289",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Monument Rd",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174035023",
            "country_code": "US",
            "telephone_number": "717-812-6425",
            "fax_number": "717-851-5250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAMMOLENTI",
        "first_name": "CAITLIN",
        "middle_name": "MARY ELLYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-27",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD485378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.