Steven Kreisher, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA052411 Issued in PA

Practice address

1100 Grampian Blvd
Williamsport, PA 17701-1909

Phone

(570) 320-7444

Fax

(570) 320-7445

NPI assigned

Jul 11, 2006

Last updated

Oct 31, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Bestpractices of Pennsylvania PC

  • Emergency Medicine Physician
  • Williamsport, PA
  • NPI 1891724662
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414713600000",
    "number": "1811922834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "address_2": "SUITE 1K",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011909",
            "telephone_number": "570-320-7444",
            "fax_number": "570-320-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREISHER",
        "first_name": "STEVEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2014-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA052411",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MA052411",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019701160002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prakash G Koshy, MD
• Mark John Kovalick, R.PH.
• Michael Andrew Kovalick Jr.
• Sarah Elizabeth Kozlowski, PA-C
• Nancy L. Krause, OTA
• Edwin James Krejci Jr., DMD
• Robin Krikorian
• Steven M. Kriner
• Mariah Kshir, PA-C
• Carly Kuhns

• Physician Assistant in Williamsport, PA
• Providers in Williamsport, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.