NPIMap

Individual provider Active NPI

Elyse Jensen

  • Pediatric Sports Medicine Physician
  • Danville, PA
National Provider Identifier
1861999435
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X
License
MD477490 Issued in PA
Practice address
16 Woodbine LN
Danville, PA 17821-8029
Phone
(570) 271-6700
Fax
(570) 214-6700
NPI assigned
Apr 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Sports Medicine Physician 2080S0010X MD477490 PA Primary

Addresses

Primary practice location

16 Woodbine LN
Danville, PA 17821-8029

Mailing address

Geisinger Medical Center 100 North Academy Avenue
Danville, PA 17822-0001
Phone (570) 271-6211

Other practice location 1

Geisinger Medical Center 100 North Academy Avenue
Danville, PA 17822-0001
Phone (570) 271-6211

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
I20240213000139 PA Practitioner - Sports MedicinePractitioner - Pediatric Medicine 2163778861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Pediatric Medicine
Education
University of Mississippi School of Medicine, 2018
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)

16 Woodbine Lane
Geisinger Optometry
Danville, PA 17822-5240
Phone (570) 271-6531

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Feb 19, 2024 Accepting new patients
Geisinger Clinic CurrentSince Feb 19, 2024 Accepting new patients
Geisinger Clinic Current Accepting new patients

Locations

16 Woodbine Ln
Danville, PA 17821
Phone (570) 271-6531

100 N Academy Ave
Danville, PA 17822

Interoperability endpoints

  • Direct secure messaging: ejensen165822@direct.geisinger.edu

Organizations & group practices 3

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 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1861999435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GEISINGER MEDICAL CENTER 100 NORTH ACADEMY AVENUE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178220001",
            "telephone_number": "570-271-6211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 WOODBINE LN",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178218029",
            "telephone_number": "570-271-6700",
            "fax_number": "570-214-6700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Geisinger Medical Center 100 North Academy Avenue",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "PA",
            "postal_code": "178220001",
            "country_code": "US",
            "telephone_number": "570-271-6211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "ELYSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-10",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "PA",
            "license": "MD477490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.