Individual provider Active NPI

Sylvia M Immel, PA-C, MMSC.

  • Physician Assistant
  • State College, PA
National Provider Identifier
1801442322
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
270 Walker Dr
State College, PA 16801-7097
Phone
(570) 326-4779
NPI assigned
Aug 12, 2019
Last updated
Aug 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA Primary

Addresses

Primary practice location

270 Walker Dr
State College, PA 16801-7097

Mailing address

1 College Ave # Dif123
Williamsport, PA 17701-5778

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
I20211117000895 PA Practitioner - Physician Assistant 8224427026 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ophelia Medical Group FL PAGroup PAC ID 7810398534, 103 clinicians

Practice addresses (Care Compare)

161 Cecil B Moore Ave
Apt 204
Philadelphia, PA 19122-3243
Phone (215) 585-2144

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Altoona CurrentSince Aug 30, 2021 Accepting new patients
Upmc Altoona CurrentSince Aug 30, 2021 Accepting new patients
Ophelia Medical Group, P.C. PastSince Mar 22, 2020 Accepting new patients

Locations

620 Howard Ave
Altoona, PA 16601
Phone (814) 889-2011

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.

NPI Registry JSON

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1801442322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 COLLEGE AVE # DIF123",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177015778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 WALKER DR",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017097",
            "telephone_number": "570-326-4779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMMEL",
        "first_name": "SYLVIA",
        "middle_name": "M",
        "credential": "PA-C, MMSC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-12",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.