NPIMap

Individual provider Active NPI

Peter Thomas Eisenhauer Jr., MD

  • Internal Medicine Physician
  • Wellsboro, PA
National Provider Identifier
1801419551
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD480212 Issued in PA
Practice address
110 Plaza LN
Wellsboro, PA 16901-1773
Phone
(570) 724-4241
NPI assigned
May 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 321716 NY
Internal Medicine Physician 207R00000X MD480212 PA Primary

Addresses

Primary practice location

110 Plaza LN
Wellsboro, PA 16901-1773

Mailing address

110 Plaza LN
Wellsboro, PA 16901-1773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230823001551 PA Practitioner - Internal Medicine 0941621650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Guthrie Medical Group PCGroup PAC ID 6002728656, 795 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858

110 Plaza LN
Wellsboro, PA 16901-1773
Phone (570) 724-4241

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

One Guthrie SQ
Sayre, PA 18840-1625

One Guthrie Square
Sayre, PA 18840-1625

Hospital & facility affiliations

  • Upmc Home Healthcare Home health agency, Williamsport, PA, CCN 397006
  • Guthrie Home Health Home health agency, Towanda, PA, CCN 397120
  • Family Hospice Hospice, Williamsport, PA, CCN 391513
  • Corning Hospital Hospital, Corning, NY, CCN 330277
  • Robert Packer Hospital Hospital, Sayre, PA, CCN 390079
  • Upmc Wellsboro Hospital, Wellsboro, PA, CCN 391316
  • Troy Community Hospital Hospital, Troy, PA, CCN 391305

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions14
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
321716NYMDInternal Medicine Physician
MD480212PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients
Guthrie Medical Group, P.C. Current Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Aug 1, 2023 Accepting new patients
Guthrie Medical Group PC Past Accepting new patients

Locations

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

110 Plaza Ln
Wellsboro, PA 16901
Phone (570) 724-4241

Interoperability endpoints

  • Direct secure messaging: peisenhauer187967@direct-guthrie.org

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.

Hospital & facility affiliations 10

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": "1590624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1801419551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 PLAZA LN",
            "city": "WELLSBORO",
            "state": "PA",
            "postal_code": "169011773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PLAZA LN",
            "city": "WELLSBORO",
            "state": "PA",
            "postal_code": "169011773",
            "telephone_number": "570-724-4241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENHAUER",
        "first_name": "PETER",
        "middle_name": "THOMAS",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-28",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "321716",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD480212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellsboro, PA

Sources for this page

Verify at the official NPI Registry.