Michael Joseph Molesevich, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA056915 Issued in PA

Practice address

21 Susquehanna Valley Mall Dr Ste a
Selinsgrove, PA 17870-9148

Phone

(570) 374-7852

Fax

(570) 374-7932

NPI assigned

Jul 14, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Family Practice Center PCGroup PAC ID 0244124212, 351 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellspan Evangelical Community Hospital Hospital, Lewisburg, PA, CCN 390013

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michaelmolesevichpa@fpc.medentdirect.com

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.

• Family Practice Center, PC

  • Physical Therapist
  • Middleburg, PA
  • NPI 1154376937

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Evangelical Medical Services Organization

  • Surgery Physician
  • Lewisburg, PA
  • NPI 1205928967
  Medicare reassignment NPD
• Evangelical Medical Services Organization

  • Urology Physician
  • Lewisburg, PA
  • NPI 1083412084
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Evangelical Community Hospital

  • General Acute Care Hospital
  • Lewisburg, PA
  • NPI 1124076039
  Care Compare affiliation

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1740697564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 DOCK HILL RD",
            "city": "MIDDLEBURG",
            "state": "PA",
            "postal_code": "178428910",
            "telephone_number": "570-837-2123",
            "fax_number": "570-837-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SUSQUEHANNA VALLEY MALL DR STE A",
            "city": "SELINSGROVE",
            "state": "PA",
            "postal_code": "178709148",
            "telephone_number": "570-374-7852",
            "fax_number": "570-374-7932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLESEVICH",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-14",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA003367",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA056915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103159304",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.