Geisinger Clinic

Organization Active NPI Family Medicine Physician · State College, PA

NPI 1639747462 · NPPES record last updated Oct 8, 2021

Key facts

NPI
1639747462
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
GEISINGER CLINIC
Practice address
293 Patriot LN
State College, PA 16803-1539
Phone
(814) 272-6770
Fax
(814) 283-6415
NPI assigned
Jun 17, 2021
Organization subpart
No

Authorized official

Name
Cindy L Mull
Title
Director
Phone
(570) 271-6603

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 272

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 272

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040130000518 PA Part B Supplier - Clinic/Group Practice 5395657001 Receives reassigned benefits from 5,323 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

Tax ID family
Geisinger Clinic Sunbury (275 organizations share this tax ID)

Locations

190 Welles St
Ste 122
Kingston, PA 18704
Phone (570) 718-4140

955 Bellefonte Ave
Lock Haven, PA 17745
Phone (570) 748-7714

1140 Quincy Ave
Scranton, PA 18510
Phone (570) 347-4420

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
207Q00000X Yes
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

293 Patriot LN
State College, PA 16803-1539

Mailing address

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

Other providers in State College, PA

All providers in State College, PA · Family Medicine Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.