NPIMap

Individual provider Active NPI

Michael Andrew Bresticker, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Danville, PA
National Provider Identifier
1871595504
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MD049632L Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-3361
Phone
(570) 271-6367
Fax
(570) 271-7142
NPI assigned
Aug 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 01048626A IN
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 55608-20 WI
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 036-079877 IL
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD049632L PA Primary

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-3361

Mailing address

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

Other identifiers 7

IdentifierTypeStateIssuer
036079877MedicaidIL
1871595504MedicaidMI
200183480EMedicaidIN
200183480AMedicaidIN
200183480CMedicaidIN
200183480DMedicaidIN
200183480BMedicaidIN

Other names 1

  • Dr. Mike Bresticker Other name

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
I20191024000638 PA Practitioner - Thoracic Surgery 5890766190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
University of Virginia School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6541

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-079877ILMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
01048626AINMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
55608-20WIMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Nov 1, 2019 Accepting new patients
Geisinger Clinic CurrentSince Nov 1, 2019 Accepting new patients
Geisinger Medical Center Past Accepting new patients

Locations

503 N 21st St
Camp Hill, PA 17011
Phone (717) 763-2100

100 N Academy Ave
Danville, PA 17822

Interoperability endpoints

  • Direct secure messaging: mbresticker229648@direct.geisinger.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 28

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

View all 28

NPI Registry JSON

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

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    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1871595504",
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        {
            "country_code": "US",
            "country_name": "United States",
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            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
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            "postal_code": "178223361",
            "telephone_number": "570-271-6367",
            "fax_number": "570-271-7142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRESTICKER",
        "first_name": "MICHAEL",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
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            "code": "208G00000X",
            "taxonomy_group": "",
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            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
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        {
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            "taxonomy_group": "",
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    "identifiers": [
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            "identifier": "200183480B",
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    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIKE",
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            "prefix": "DR.",
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            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.