Susquehanna Physician Services
Organization Active NPI Emergency Medicine Physician · Williamsport, PA
NPI 1992359798 · NPPES record last updated Jul 30, 2019
Key facts
- NPI
- 1992359798
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- SUSQUEHANNA PHYSICIAN SERVICES
- Practice address
- 700 High St
Williamsport, PA 17701-3100 - Phone
- (570) 321-2125
- Fax
- (570) 321-2192
- NPI assigned
- Jul 30, 2019
- Organization subpart
- No
Authorized official
- Name
- Loretta V Myers, CPCS, PESC
- Title
- Credentialing Coordinator
- Phone
- (570) 320-7838
Other NPIs on the same Medicare enrollment 1
Practitioners 55
-
Laura Mae Aguirre, CRNP
-
Angela L Alexander, CRNP
-
Brett Beel, M.D.
-
Pravinchandra G. Chapla, M.D.
-
Andrew Czap, PA-C
-
Emily Delgado, DO
-
Christopher Gephart, PA-C
-
Cameron Glagola, DO
-
Francis Guyette, MD
-
Taylor Haas, DO, MBA
-
Sara Hencel, PA-C
-
Bryan Hoover, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040412001371 | PA | Part B Supplier - Clinic/Group Practice | 2264336460 |
Receives reassigned benefits from 143 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Muncy, PA; Williamsport, PA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes |
Addresses
Primary practice location
700 High St
Williamsport, PA 17701-3100
Mailing address
1201 Grampian Blvd
Williamsport, PA 17701-1900
Other names
- Susquehanna Health Medical Group
Other providers in Williamsport, PA
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- Susquehanna Physician Services
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- Susquehanna Physician Services
- Susquehanna Physician Services
- Susquehanna Physician Services
- Susquehanna Physician Services
- Susquehanna Physician Services
- Susquehanna Urologic Associates LTD
- Susquehanna Valley Vein Center, LLC
All providers in Williamsport, PA · Emergency 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 Jul 30, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.