Individual provider Active NPI

Michelle Jarvis, PA-C

  • Medical Physician Assistant
  • Altoona, PA
National Provider Identifier
1730502832
Registry record updated Jan 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA056725 Issued in PA
Practice address
810 Valley View Blvd
Altoona, PA 16602-6342
Phone
(814) 946-5469
NPI assigned
Jan 24, 2014
Last updated
Jan 11, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA056725 PA Primary

Addresses

Primary practice location

810 Valley View Blvd
Altoona, PA 16602-6342

Mailing address

810 Valley View Blvd
Altoona, PA 16602-6342
Phone (814) 946-5469

Other names 1

  • Michelle Kutruff Former name

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
I20140308000252 PA Practitioner - Physician Assistant 4981834140 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Gastroenterology Associates of Lancaster, LTD.Group PAC ID 4688575434, 248 clinicians

Practice addresses (Care Compare)

2112 Harrisburg Pike
Suite 202
Lancaster, PA 17601-2644
Phone (717) 869-4600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Altoona CurrentSince May 11, 2015 Accepting new patients
Midatlantic Endoscopy LLC Current Accepting new patients
Regional Gastroenterology Associates of Lancaster, LTD. CurrentSince Oct 1, 2023 Accepting new patients
Upmc Altoona CurrentSince May 11, 2015 Accepting new patients

Locations

501 Howard Ave
Ste F2
Altoona, PA 16601
Phone (814) 889-2020

620 Howard Ave
Altoona, PA 16601
Phone (814) 889-2011

2112 Harrisburg Pike
Ste 202
Lancaster, PA 17601
Phone (717) 544-3500

Organizations & group practices 6

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 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": "1390521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1730502832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 VALLEY VIEW BLVD",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166026342",
            "telephone_number": "814-946-5469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 VALLEY VIEW BLVD",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166026342",
            "telephone_number": "814-946-5469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARVIS",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-24",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA056725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "KUTRUFF",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Altoona, PA

Sources for this page

Verify at the official NPI Registry.