Individual provider Active NPI

Miranda Louise Geyer, PA-C

  • Family Medicine Physician
  • Leola, PA
National Provider Identifier
1730808460
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MA063873 Issued in PA
Practice address
146 E Main St
Leola, PA 17540-1964
Phone
(717) 656-2141
NPI assigned
Aug 25, 2022
Last updated
Aug 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MA063873 PA Primary

Addresses

Primary practice location

146 E Main St
Leola, PA 17540-1964

Mailing address

825 N Hanover St
Elizabethtown, PA 17022-1304
Phone (717) 381-5207

Other names 1

  • Miranda Louise Kelly 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
I20221101003381 PA Practitioner - Physician Assistant 4082081146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lancaster General Medical GroupGroup PAC ID 0941103683, 590 clinicians

Practice addresses (Care Compare)

146 E Main St
Leola, PA 17540-1964

3045 Marietta Ave
Lancaster, PA 17601-1321
Phone (717) 299-4644

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA063873PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster General Medical Group CurrentSince Nov 28, 2022 Accepting new patients
Lancaster General Medical Group Family Medicine CurrentSince Nov 28, 2022 Accepting new patients
Lancaster General Medical Group Family Medicine Past Accepting new patients

Locations

3045 Marietta Ave
Lancaster, PA 17601
Phone (717) 299-4644

146 E Main St
Leola, PA 17540
Phone (717) 646-2141

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.

Hospital & facility affiliations 3

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": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1730808460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 N HANOVER ST",
            "city": "ELIZABETHTOWN",
            "state": "PA",
            "postal_code": "170221304",
            "telephone_number": "717-381-5207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 E MAIN ST",
            "city": "LEOLA",
            "state": "PA",
            "postal_code": "175401964",
            "telephone_number": "717-656-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEYER",
        "first_name": "MIRANDA",
        "middle_name": "LOUISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-25",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MA063873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRANDA",
            "last_name": "KELLY",
            "middle_name": "LOUISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Leola, PA

Sources for this page

Verify at the official NPI Registry.