Kirsten Elizabeth Shadle, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA058015 Issued in PA

Practice address

100 N Academy Ave
Danville, PA 17822-2050

Phone

(570) 214-7967

Fax

(570) 214-2800

NPI assigned

Mar 9, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Kirsten Elizabeth Wetzel Former name

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vision Innovation Centers of Pennsylvania LLCGroup PAC ID 0840625349, 86 clinicians

Conestoga Eye PCGroup PAC ID 1456669894, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kirsten.shadle@vip.emadirect.md

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.

• Conestoga Eye PC

  • Ophthalmology Physician
  • Lancaster, PA
  • NPI 1952780520
  Medicare reassignment Care Compare group
• Vision Innovation Centers of Pennsylvania LLC

  • Ophthalmology Physician
  • Kingston, PA
  • NPI 1962046458
  Medicare reassignment Care Compare group
• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment
• Infinite Medical PC

  • Family Medicine Physician
  • Bristol, RI
  • NPI 1407483175

  PA

  Medicare reassignment
• Geisinger Clinic

  • Family Medicine Physician
  • Wilkes Barre, PA
  • NPI 1073638201

  Physician Assistant

  NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD
• Vision Innovation Centers of Pennsylvania LLC

  • Optician
  • West Reading, PA
  • NPI 1811608078
  NPD
• Vision Innovation Centers of Pennsylvania, LLC

  • Durable Medical Equipment & Medical Supplies
  • Bloomsburg, PA
  • NPI 1275177602
  NPD
• Geisinger Clinic

  • Hospitalist Physician
  • Wilkes Barre, PA
  • NPI 1588614358
  NPD (past)
• Vision Innovation Centers of Pennsylvania LLC

  • Durable Medical Equipment & Medical Supplies
  • Nanticoke, PA
  • NPI 1104460542
  NPD (past)

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

{
    "created_epoch": "1425859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1740673243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178222050",
            "telephone_number": "570-214-7967",
            "fax_number": "570-214-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADLE",
        "first_name": "KIRSTEN",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-09",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA003496",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "OA003496",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA058015",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA058015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIRSTEN",
            "last_name": "WETZEL",
            "middle_name": "ELIZABETH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Seneca, CRNP
• Jake Sequeira, MD
• Judith A. Serra, CRNA
• Ronald Seymour III
• Robert B. Shabanowitz, PH.D.
• Anne Shaffer, DMD
• Tana M. Shaffer, D.O.
• Umber Shafique, M.D
• Madeeha Shafqat, M.D
• Chandresh R Shah, M.D.

• Physician Assistant in Danville, PA
• Providers in Danville, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.