NPIMap

Individual provider Active NPI

Bryce Alden Petersheim, PA-C

  • Surgical Physician Assistant
  • Danville, PA
National Provider Identifier
1629589981
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
MA059444 Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-9800
Phone
(570) 271-6211
NPI assigned
Oct 13, 2017
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA059444 PA Primary

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-9800

Mailing address

100 N Academy Ave
Danville, PA 17822-9800

Other practice location 1

301 S 7th Ave Ste 3220
West Reading, PA 19611-1493
Phone (484) 628-2663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171129002599 PA Practitioner - Physician Assistant 4082971080 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Berks Ortho LLCGroup PAC ID 2365961950, 8 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

301 S 7TH Ave
Suite 3220
West Reading, PA 19611-1493
Phone (484) 628-2663

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Keystone Orthopaedic Specialists LLC CurrentSince Aug 5, 2024 Accepting new patients
Geisinger Clinic CurrentSince Dec 4, 2017 Accepting new patients
Keystone Orthopaedic Specialists LLC CurrentSince Aug 5, 2024 Accepting new patients
Geisinger Clinic CurrentSince Dec 4, 2017 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

11 Fairlane Rd
Reading, PA 19606
Phone (610) 378-8810

301 S 7th Ave
Ste 3220
West Reading, PA 19611
Phone (484) 628-2663

2201 Ridgewood Rd
Ste 250
Wyomissing, PA 19610
Phone (610) 372-7429

2758 Century Blvd
Ste 2
Wyomissing, PA 19610
Phone (610) 376-5646

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1507852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1629589981",
    "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": "178229800"
        },
        {
            "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": "178229800",
            "telephone_number": "570-271-6211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 S 7th Ave Ste 3220",
            "address_purpose": "LOCATION",
            "city": "West Reading",
            "state": "PA",
            "postal_code": "196111493",
            "country_code": "US",
            "telephone_number": "484-628-2663",
            "fax_number": "484-628-2621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSHEIM",
        "first_name": "BRYCE",
        "middle_name": "ALDEN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-13",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA059444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.