NPIMap

Individual provider Active NPI

Lori Victor Masteller, DO

  • Family Medicine Physician
  • Bloomsburg, PA
National Provider Identifier
1841283538
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS010659L Issued in PA
Practice address
6850 Lows Rd
Ste 325
Bloomsburg, PA 17815-8708
Phone
(570) 784-5545
Fax
(570) 245-0240
NPI assigned
Aug 26, 2005
Last updated
Nov 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS010659L PA Primary

Addresses

Primary practice location

6850 Lows Rd
Ste 325
Bloomsburg, PA 17815-8708

Mailing address

7 Dock Hill Rd
Middleburg, PA 17842-8910
Phone (570) 837-2123

Other identifiers 2

IdentifierTypeStateIssuer
0019154280002MedicaidPA
2K3370OtherPAMEDICARE (FAMILY PRACTICE CENTER PC)

Other names 1

  • Lori Metrishyn Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lorimastellerdo@fpc.medentdirect.com Health Information Exchange (HIE) FAMILY PRACTICE CENTER, PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040916000605 PA Practitioner - Family Practice 9436126554 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Practice Center PCGroup PAC ID 0244124212, 351 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

1 Dock Hill Rd
Middleburg, PA 17842-8910
Phone (570) 837-5889

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

6850 Lows Rd
Suite 325B
Bloomsburg, PA 17815-8708
Phone (570) 784-5545

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice Center, PC CurrentSince Nov 1, 2022 Accepting new patients
Family Practice Center, PC Multi-Specialty CurrentSince Nov 1, 2022 Accepting new patients
Susquehanna Valley Medical Specialties, PC Multi-Specialty CurrentSince Aug 1, 2004 Accepting new patients
Bloomsburg Physicians Services Multi-Specialty Past Accepting new patients

Locations

6850 Lows Rd
Bloomsburg, PA 17815
Phone (570) 784-6243

6850 Lows Rd
Ste 325
Bloomsburg, PA 17815
Phone (570) 784-5545

6850 Lows Rd
Ste 325B
Bloomsburg, PA 17815
Phone (570) 317-2763

7 Dock Hill Rd
Middleburg, PA 17842
Phone (570) 837-2123

270 Susquehanna Valley Mall Dr
Ste 300
Selinsgrove, PA 17870
Phone (570) 743-1703

1205 River Ave
#1
Williamsport, PA 17701
Phone (570) 323-5991

Interoperability endpoints

  • Direct secure messaging: lorimastellerdo@fpc.medentdirect.com

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.

Hospital & facility affiliations 41

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1841283538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 DOCK HILL RD",
            "city": "MIDDLEBURG",
            "state": "PA",
            "postal_code": "178428910",
            "telephone_number": "570-837-2123",
            "fax_number": "570-837-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 LOWS RD",
            "address_2": "STE 325",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178158708",
            "telephone_number": "570-784-5545",
            "fax_number": "570-245-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTELLER",
        "first_name": "LORI",
        "middle_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-26",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS010659L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019154280002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE (FAMILY PRACTICE CENTER PC)",
            "identifier": "2K3370",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lorimastellerdo@fpc.medentdirect.com",
            "affiliation": "Y",
            "affiliationName": "FAMILY PRACTICE CENTER, PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "6850 Lows Rd",
            "address_2": "STE 325",
            "city": "Bloomsburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178158708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "METRISHYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bloomsburg, PA

Sources for this page

Verify at the official NPI Registry.