Individual provider Active NPI

Bernadette M Trostle, PA

  • Medical Physician Assistant
  • Pottsville, PA
National Provider Identifier
1811093503
Registry record updated Mar 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA003069L Issued in PA
Practice address
48 Tunnel Rd
Suite 203
Pottsville, PA 17901-3875
Phone
(570) 622-5455
Fax
(570) 622-5493
NPI assigned
Sep 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA003069L PA Primary

Addresses

Primary practice location

48 Tunnel Rd
Suite 203
Pottsville, PA 17901-3875

Mailing address

33 Hickory LN
Auburn, PA 17922-9094
Phone (570) 754-7358

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
I20060105000204 PA Practitioner - Physician Assistant 9931122033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Medical Group P CGroup PAC ID 1355247180, 105 clinicians

Practice addresses (Care Compare)

219 S Balliet St
Frackville, PA 17931-2105
Phone (570) 874-3404

420 S Jackson St
Pottsville, PA 17901-3625
Phone (570) 621-5000

431 Dowdentown Rd
Pottsville, PA 17901-9111
Phone (570) 399-5235

48 Tunnel Rd
Pottsville, PA 17901-3875

Hospital & facility affiliations

  • Geisinger St. Luke'S Hospital Hospital, Orwigsburg, PA, CCN 390332
  • Schuylkill Medical Center - South Jackson Street Hospital, Pottsville, PA, CCN 390030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA003069LPAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Medical Group, P.C. CurrentSince Apr 7, 2014 Accepting new patients

Locations

219 S Balliet St
Frackville, PA 17931
Phone (570) 874-3404

82 Tunnel Rd
Pottsville, PA 17901
Phone (570) 622-5455

48 Tunnel Rd
Ste 104
Pottsville, PA 17901
Phone (570) 622-5555

420 S Jackson St
Pottsville, PA 17901
Phone (570) 621-5000

700 E Norwegian St
Pottsville, PA 17901
Phone (570) 621-4000

48 Tunnel Rd
Ste 203
Pottsville, PA 17901
Phone (570) 622-5455

431 Dowdentown Rd
Pottsville, PA 17901
Phone (570) 399-5235

Organizations & group practices 2

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 3

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394150400000",
    "number": "1811093503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 HICKORY LN",
            "city": "AUBURN",
            "state": "PA",
            "postal_code": "179229094",
            "telephone_number": "570-754-7358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 TUNNEL RD",
            "address_2": "SUITE 203",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013875",
            "telephone_number": "570-622-5455",
            "fax_number": "570-622-5493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROSTLE",
        "first_name": "BERNADETTE",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2014-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA003069L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pottsville, PA

Sources for this page

Verify at the official NPI Registry.