NPIMap

Organization Active NPI

Wellspan Medical Group

Doing business as WellSpan Interventional Radiology

  • Vascular & Interventional Radiology Physician
  • Lebanon, PA
National Provider Identifier
1831947126
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
WELLSPAN MEDICAL GROUP
Doing business as
WellSpan Interventional Radiology
Practice address
735 Norman Dr
Lebanon, PA 17042-7559
Phone
(717) 639-3074
NPI assigned
May 10, 2024
Last updated
May 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Authorized official

Name
Jennifer Elaine Sweitzer
Title
Director
Phone
(717) 851-6838

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X NU Primary
Nurse Practitioner 363L00000X NU

Addresses

Primary practice location

735 Norman Dr
Lebanon, PA 17042-7559

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 851-1405

Other practice location 1

804 Grandview Dr
Ephrata, PA 17522-1681
Phone (717) 639-3074

Other names 1

  • WellSpan Interventional Radiology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040220000815 PA Part B Supplier - Clinic/Group Practice 1951213115 Receives reassigned benefits from 3,390 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
York Health Systems Med177 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1715299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715299200000",
    "number": "1831947126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 NORMAN DR",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427559",
            "telephone_number": "717-639-3074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "804 Grandview Dr",
            "address_purpose": "LOCATION",
            "city": "Ephrata",
            "state": "PA",
            "postal_code": "175221681",
            "country_code": "US",
            "telephone_number": "717-639-3074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WELLSPAN MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-10",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A",
        "authorized_official_last_name": "SWEITZER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "717-851-6838"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellSpan Interventional Radiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.