Individual provider Active NPI

Alyssa Lee Maddalena, PA-C

  • Physician Assistant
  • Danville, PA
National Provider Identifier
1649607144
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA056397 Issued in PA
Practice address
16 Woodbine LN
Danville, PA 17821-8029
Phone
(570) 271-6070
Fax
(570) 271-5609
NPI assigned
Sep 30, 2013
Last updated
Oct 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA056397 PA Primary
Physician Assistant 363A00000X OA003133 PA

Addresses

Primary practice location

16 Woodbine LN
Danville, PA 17821-8029

Mailing address

100 N Academy Ave
Credentials Dept
Danville, PA 17822-4903
Phone (570) 271-6144

Other names 1

  • Alyssa L. Lamotte Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address agundrum112254@direct.geisinger.edu Direct

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
I20131211001233 PA Practitioner - Physician Assistant 5294962551 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA056397PAMDPhysician Assistant
OA003133PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Nov 11, 2013 Accepting new patients
Geisinger Clinic Physician Assistant CurrentSince Nov 11, 2013 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

2200 W Front St
Berwick, PA 18603
Phone (570) 759-1228

2407 Reichart Rd
Bloomsburg, PA 17815
Phone (570) 784-6320

4200 Hospital Rd
Coal Township, PA 17866
Phone (570) 644-4200

100 N Academy Ave
Danville, PA 17822

16 Woodbine Ln
Danville, PA 17821
Phone (570) 271-6531

106 S Market St
Elysburg, PA 17824
Phone (570) 672-2574

Interoperability endpoints

  • Direct secure messaging: agundrum112254@direct.geisinger.edu

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1649607144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "address_2": "CREDENTIALS DEPT",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 WOODBINE LN",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178218029",
            "telephone_number": "570-271-6070",
            "fax_number": "570-271-5609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDALENA",
        "first_name": "ALYSSA",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-30",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA056397",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA003133",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agundrum112254@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "16 Woodbine Ln",
            "city": "Danville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178218029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "LAMOTTE",
            "middle_name": "L.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.