Individual provider Active NPI

Kimberly Ann Slusser, M.D.

  • Pediatrics Physician
  • Lititz, PA
National Provider Identifier
1801895214
Registry record updated Mar 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
23792 Issued in OK
Practice address
6 W Newport Rd
Lititz, PA 17543-7774
Phone
(717) 627-2108
Fax
(717) 627-2434
NPI assigned
Jul 18, 2005
Last updated
Mar 31, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 23792 OK Primary

Addresses

Primary practice location

6 W Newport Rd
Lititz, PA 17543-7774

Mailing address

6 W Newport Rd
Lititz, PA 17543-7774
Phone (717) 627-2108

Other identifiers 1

IdentifierTypeStateIssuer
200038960AMedicaidOK

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110726000296 PA Practitioner - Pediatric Medicine 0345299475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Pennsylvania State University College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6 W Newport Rd
Penn State Med GRP Cornerstone
Lititz, PA 17543-7774
Phone (717) 627-2108

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Penn State Health Medical Group, LLC CurrentSince Oct 1, 2017 Accepting new patients
Penn State Health Medical Group, LLC Current Accepting new patients
Penn State Health Medical Group, LLC Pediatrics CurrentSince Oct 1, 2017 Accepting new patients
Springer Clinic Inc Past Accepting new patients
Penn State Health Medical Group, LLC Past Accepting new patients

Locations

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

3045 Marietta Ave
Lancaster, PA 17601
Phone (717) 299-4644

6 W Newport Rd
Lititz, PA 17543
Phone (717) 581-5255

Organizations & group practices 5

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396224000000",
    "number": "1801895214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 W NEWPORT RD",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175437774",
            "telephone_number": "717-627-2108",
            "fax_number": "717-627-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 W NEWPORT RD",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175437774",
            "telephone_number": "717-627-2108",
            "fax_number": "717-627-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLUSSER",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2014-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "23792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200038960A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lititz, PA

Sources for this page

Verify at the official NPI Registry.