Pinnacle Health Regional Physicians
Organization Active NPI Family Medicine Physician · Lancaster, PA
NPI 1982124129 · NPPES record last updated Feb 12, 2019
Key facts
- NPI
- 1982124129
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- PINNACLE HEALTH REGIONAL PHYSICIANS
- Practice address
- 233 College Ave Ste 302
Lancaster, PA 17603-3384 - Phone
- (717) 291-8512
- Fax
- (717) 291-8547
- NPI assigned
- Jun 20, 2017
- Organization subpart
- No
Authorized official
- Name
- Christopher P. Markley
- Title
- Sr VP, Strat SVCS/Gen Counsel
- Phone
- (717) 231-8210
Corporate family (same tax ID) 14
Practitioners 12
-
Brittany E Barker, D.O.
-
Douglas Brenneman, D.O.
-
Jeffrey K Chen, MD
-
Kaitlin L Feldenzer, CRNP
-
Lisa A Hardy, CRNP
-
James A. Lease, D.O.
-
Niloofar Vahid Roodsari, D.O.
-
Tina Rosengrant, CRNP
-
Katie Watkins, CNM
-
Daniel Michael Weiss I, PA-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D0917572 | College Avenue Family Medicine | Certificate of waiver | Sep 30, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170810001731 | PA | Part B Supplier - Clinic/Group Practice | 7416228358 |
Receives reassigned benefits from 514 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Pinnacle Health Regional Physicians
Locations
233 College Ave
Ste 302
Lancaster, PA 17603
Phone (717) 291-8512
233 College Ave
#300302
Lancaster, PA 17603
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Internal Medicine Physician |
207R00000X | |||
| Pediatrics Physician |
208000000X |
Addresses
Primary practice location
233 College Ave Ste 302
Lancaster, PA 17603-3384
Mailing address
409 S 2ND St Ste 2F
Harrisburg, PA 17104-1612
Other names
- College Avenue Family Medicine
Other providers in Lancaster, PA
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- Pinnacle Health Regional Physicians
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- Pinnacle Health Regional Physicians
- Pinnacle Health Regional Physicians
- Pinnacle Health Regional Physicians
- Pinnacle Home Care LLC
- Pinnacle Home Therapy, LLC
- Pamela Christine Pinto Pannafino
- Jennie Lou Callora Pintor
All providers in Lancaster, PA · Family Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.