Individual provider Active NPI

Lara L Stellwag, CNM

  • Advanced Practice Midwife
  • Bloomsburg, PA
National Provider Identifier
1760974844
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
MW010665 Issued in PA
Practice address
425 E 1St St
Bloomsburg, PA 17815-1480
Phone
(570) 387-2474
Fax
(570) 387-2397
NPI assigned
Jun 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 25ME00065100 NJ
Advanced Practice Midwife 367A00000X 25ME00065101 NJ
Advanced Practice Midwife 367A00000X MW010665 PA Primary

Addresses

Primary practice location

425 E 1St St
Bloomsburg, PA 17815-1480

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other names 1

  • Lara Alminde Other 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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220203002494 PA Practitioner - Certified Nurse Midwife (CNM) 3173875515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

425 E 1St St
Bloomsburg, PA 17815-1480
Phone (570) 416-1816

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
25ME00065101NJMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Feb 28, 2022 Accepting new patients
Geieinger Clinic CurrentSince Feb 28, 2022 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

2200 W Front St
Berwick, PA 18603
Phone (570) 759-1228

549 Fair St
Bloomsburg, PA 17815
Phone (570) 387-2100

6850 Lows Rd
Bloomsburg, PA 17815
Phone (570) 784-6243

425 E 1st St
Bloomsburg, PA 17815
Phone (570) 387-2474

100 N Academy Ave
Danville, PA 17822

1020 Thompson St
Jersey Shore, PA 17740
Phone (570) 398-0100

400 Highland Ave
Lewistown, PA 17044
Phone (717) 242-7473

1800 Mulberry St
Scranton, PA 18510
Phone (570) 703-7351

Interoperability endpoints

  • Direct secure messaging: lstellwag492476@direct.geisinger.edu

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1760974844",
    "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",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E 1ST ST",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178151480",
            "telephone_number": "570-387-2474",
            "fax_number": "570-387-2397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STELLWAG",
        "first_name": "LARA",
        "middle_name": "L",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-04",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NJ",
            "license": "25ME00065100",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NJ",
            "license": "25ME00065101",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "PA",
            "license": "MW010665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARA",
            "last_name": "ALMINDE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bloomsburg, PA

Sources for this page

Verify at the official NPI Registry.