NPIMap

Individual provider Active NPI

Mark Edward Lavallee, MD

  • Sports Medicine (Family Medicine) Physician
  • Mechanicsburg, PA
National Provider Identifier
1679564330
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
MD060390L Issued in PA
Practice address
2005 Technology Pkwy Ste 100
Mechanicsburg, PA 17050-9413
Phone
(717) 791-2620
Fax
(717) 791-2621
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD060390L PA
Sports Medicine (Family Medicine) Physician 207QS0010X 01049328A IN
Sports Medicine (Family Medicine) Physician 207QS0010X MD060390L PA Primary

Addresses

Primary practice location

2005 Technology Pkwy Ste 100
Mechanicsburg, PA 17050-9413

Mailing address

2005 Technology Pkwy Ste 100
Mechanicsburg, PA 17050-9413
Phone (717) 791-2620

Other practice location 1

1207 S Queen St
York, PA 17403-3922
Phone (717) 846-8869

Other practice location 2

320 Market St Ste 165
Harrisburg, PA 17101-2225
Phone (717) 988-9330

Other practice location 3

1830 Good Hope Rd
Enola, PA 17025-1233
Phone (717) 988-8135

Other practice location 4

689 Yorktown Rd Ste 204
Lewisberry, PA 17339-9258
Phone (717) 988-8351

Other identifiers 4

IdentifierTypeStateIssuer
200198600MedicaidIN
002980953OtherPAHIGHMARK BLUE SHIELD
068809600MedicaidMD
102855069MedicaidPA

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
I20130925000331 PA Practitioner - Sports MedicinePractitioner - Family Practice 1951385434 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
Pennsylvania State University College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pinnacle Health Medical Services 1,025 clinicians

Practice addresses (Care Compare)

2005 Technology Pkwy
Mechanicsburg, PA 17050-9413
Phone (717) 791-2620

Hospital & facility affiliations

  • Upmc Pinnacle Hospitals Hospital, Harrisburg, PA, CCN 390067
  • Upmc Memorial Hospital, York, PA, CCN 390101

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
York Hospital Family Medicine CurrentSince Sep 3, 2013 Accepting new patients
Wellspan Medical Group CurrentSince Sep 3, 2013 Accepting new patients
Pinnacle Health Regional Physicians Family Medicine CurrentSince Jan 24, 2021 Accepting new patients
York Hospital CurrentSince Sep 3, 2013 Accepting new patients
York Hospital Current Accepting new patients
Wellspan Medical Group Current Accepting new patients
Pinnacle Health Regional Physicians Family Medicine CurrentSince Jan 24, 2021 Accepting new patients
Pinnacle Health Medical Services CurrentSince Oct 14, 2020 Accepting new patients
Pinnacle Health Medical Services Family Medicine Current Accepting new patients
Pinnacle Health Medical Services CurrentSince Oct 14, 2020 Accepting new patients
Wellspan Medical Group Family Medicine CurrentSince Sep 3, 2013 Accepting new patients
Pinnacle Health Medical Services Past Accepting new patients

Locations

210 Forge Rd
Boiling Springs, PA 17007
Phone (717) 249-8300

1830 Good Hope Rd
Enola, PA 17025
Phone (717) 732-8877

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

320 Market St
Ste 165
Harrisburg, PA 17101
Phone (717) 988-9330

4310 Londonderry Rd
Ste 1
Harrisburg, PA 17109
Phone (717) 561-4242

689 Yorktown Rd
Ste 204
Lewisberry, PA 17339
Phone (717) 988-8351

2005 Technology Pkwy
Ste 100
Mechanicsburg, PA 17050
Phone (717) 791-2620

1207 S Queen St
York, PA 17403
Phone (717) 846-8869

605 S George St
Ste 200
York, PA 17401
Phone (717) 851-2334

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

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

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

1001 S George St
Bldg Mkb
York, PA 17403
Phone (717) 851-2521

Interoperability endpoints

  • Direct secure messaging: mlavallee538258@upmc.direct-ci.com

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 9

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1679564330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 TECHNOLOGY PKWY STE 100",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170509413",
            "telephone_number": "717-791-2620",
            "fax_number": "717-791-2621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 TECHNOLOGY PKWY STE 100",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170509413",
            "telephone_number": "717-791-2620",
            "fax_number": "717-791-2621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1207 S Queen St",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174033922",
            "country_code": "US",
            "telephone_number": "717-846-8869",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "320 Market St Ste 165",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171012225",
            "country_code": "US",
            "telephone_number": "717-988-9330",
            "fax_number": "717-221-5690",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1830 Good Hope Rd",
            "address_purpose": "LOCATION",
            "city": "Enola",
            "state": "PA",
            "postal_code": "170251233",
            "country_code": "US",
            "telephone_number": "717-988-8135",
            "fax_number": "717-221-5600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "689 Yorktown Rd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Lewisberry",
            "state": "PA",
            "postal_code": "173399258",
            "country_code": "US",
            "telephone_number": "717-988-8351",
            "fax_number": "717-221-5480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAVALLEE",
        "first_name": "MARK",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD060390L",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IN",
            "license": "01049328A",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "PA",
            "license": "MD060390L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200198600",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "002980953",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "068809600",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102855069",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsburg, PA

Sources for this page

Verify at the official NPI Registry.