Individual provider Active NPI

Nicole Sipple, PA-C

  • Physician Assistant
  • Scranton, PA
National Provider Identifier
1861814774
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA056630 Issued in PA
Practice address
3 W Olive St
Scranton, PA 18508-2572
Phone
(570) 207-4054
Fax
(570) 207-4057
NPI assigned
Jan 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA056630 PA
Physician Assistant 363A00000X MA056630 PA Primary

Addresses

Primary practice location

3 W Olive St
Scranton, PA 18508-2572

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nsipple133792@direct.geisinger.edu Direct

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
I20160809000164 PA Practitioner - Physician Assistant 6507184058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

114 LT Michael Cleary Dr
Dallas, PA 18612-1649
Phone (570) 255-1178

1155 E Mountain Blvd
Wilkes Barre, PA 18702-7906
Phone (570) 808-5135

1175 E Mountain Blvd
Suite 150723
Wilkes Barre, PA 18702-7906
Phone (570) 808-1093

128 E Main St
Nanticoke, PA 18634-1604
Phone (570) 258-1304

3 W Olive St
Scranton, PA 18508-2572
Phone (570) 207-5970

35 S Mountain Blvd
Mountain Top, PA 18707-1122
Phone (570) 474-5847

560 Pierce St
Kingston, PA 18704-5716
Phone (570) 714-5810

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA056630PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Jul 5, 2016 Accepting new patients
Geisinger Clinic CurrentSince Jul 5, 2016 Accepting new patients
Geisinger-HM Joint Venture, LLC Physician Assistant CurrentSince Mar 22, 2021 Accepting new patients
Geisinger-HM Joint Venture, LLC CurrentSince Mar 22, 2021 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

226 Buckaroo Ln
Bellefonte, PA 16823
Phone (814) 353-1030

174 Buckaroo Ln
Bellefonte, PA 16823
Phone (814) 353-1030

425 E 1st St
Bloomsburg, PA 17815
Phone (570) 387-2474

224 N Logan Blvd
Burnham, PA 17009
Phone (717) 242-0196

114 Lt Michael Cleary Dr
Dallas, PA 18612
Phone (570) 255-1178

100 N Academy Ave
Danville, PA 17822

560 Pierce St
Kingston, PA 18704
Phone (570) 283-2161

68 Spring St
Lock Haven, PA 17745
Phone (570) 263-5830

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

128 E Main St
Nanticoke, PA 18634
Phone (570) 258-1304

42 N Main St
Pittston, PA 18640
Phone (570) 602-5610

3 W Olive St
Scranton, PA 18508
Phone (570) 207-4054

1630 N Atherton St
State College, PA 16803
Phone (814) 238-1279

10 Trieble Dr
Tunkhannock, PA 18657
Phone (570) 836-2273

35 S Mountain Blvd
Wilkes Barre, PA 18707
Phone (570) 474-5072

1824 E 3rd St
Williamsport, PA 17701
Phone (570) 322-4422

Interoperability endpoints

  • Direct secure messaging: nsipple133792@direct.geisinger.edu
  • Direct secure messaging: nicole.sipple.1@6565.direct.athenahealth.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1389398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1861814774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 W OLIVE ST",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185082572",
            "telephone_number": "570-207-4054",
            "fax_number": "570-207-4057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIPPLE",
        "first_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-11",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA056630",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA056630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nsipple133792@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3 W Olive St",
            "city": "Scranton",
            "state": "PA",
            "country_code": "US",
            "postal_code": "185082572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.