Individual provider Active NPI

Caroline Reist Buckwalter, PA-C

  • Physician Assistant
  • Marietta, PA
National Provider Identifier
1942434865
Registry record updated Dec 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1159 River Rd
Marietta, PA 17547-1628
Phone
(717) 426-1131
Fax
(717) 544-4251
NPI assigned
May 6, 2009
Last updated
Dec 15, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

1159 River Rd
Marietta, PA 17547-1628

Mailing address

1351 Prospect Rd
Columbia, PA 17512-9308
Phone (717) 808-8670

Other names 1

  • Caroline Elizabeth Reist Former name

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
I20090921000313 PA Practitioner - Physician Assistant 2062568876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lancaster General Medical GroupGroup PAC ID 0941103683, 590 clinicians

Practice addresses (Care Compare)

1159 River Rd
Marietta, PA 17547-1628
Phone (717) 426-1131

3045 Marietta Ave
Lancaster, PA 17601-1321
Phone (717) 299-4644

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster General Medical Group CurrentSince Feb 26, 2018 Accepting new patients
Lancaster General Medical Group CurrentSince Feb 26, 2018 Accepting new patients
Lancaster General Medical Group Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

3045 Marietta Ave
Lancaster, PA 17601
Phone (717) 299-4644

555 N Duke St
Lancaster, PA 17602
Phone (717) 544-5945

1159 River Rd
Marietta, PA 17547
Phone (717) 426-1131

1159 River Rd
#F
Marietta, PA 17547
Phone (717) 426-1131

Interoperability endpoints

  • Direct secure messaging: cbuckwalter175055@direct-lghealth.org

Organizations & group practices 5

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513296000000",
    "number": "1942434865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 PROSPECT RD",
            "city": "COLUMBIA",
            "state": "PA",
            "postal_code": "175129308",
            "telephone_number": "717-808-8670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1159 RIVER RD",
            "city": "MARIETTA",
            "state": "PA",
            "postal_code": "175471628",
            "telephone_number": "717-426-1131",
            "fax_number": "717-544-4251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKWALTER",
        "first_name": "CAROLINE",
        "middle_name": "REIST",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-06",
        "last_updated": "2017-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLINE",
            "last_name": "REIST",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marietta, PA

Sources for this page

Verify at the official NPI Registry.