NPIMap

Individual provider Active NPI

Lisdeymi Prieto Yanes, PA-C

  • Physician Assistant
  • Port Matilda, PA
National Provider Identifier
1992524482
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA066134 Issued in PA
Practice address
132 Abigail LN
Port Matilda, PA 16870-7153
Phone
(814) 272-7100
Fax
(814) 272-6519
NPI assigned
Oct 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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 MA066134 PA Primary

Addresses

Primary practice location

132 Abigail LN
Port Matilda, PA 16870-7153

Mailing address

104 Forest Glen Cir
Port Matilda, PA 16870-7124
Phone (678) 313-0652

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
I20241220002146 PA Practitioner - Physician Assistant 4082141619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
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) 271-6144

132 Abigail LN
Port Matilda, PA 16870-7153
Phone (814) 272-7100

210 Medical Ctr Dr
Philipsburg, PA 16866-1948
Phone (814) 342-8020

400 Highland Ave
Lewistown, PA 17044-1167
Phone (717) 363-9071

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Dec 16, 2024 Accepting new patients
Geisinger Clinic CurrentSince Dec 16, 2024 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

132 Abigail Ln
Port Matilda, PA 16870
Phone (814) 272-5011

Interoperability endpoints

  • Direct secure messaging: lprietoyanes618721@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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1728518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1992524482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 FOREST GLEN CIR",
            "city": "PORT MATILDA",
            "state": "PA",
            "postal_code": "168707124",
            "telephone_number": "678-313-0652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 ABIGAIL LN",
            "city": "PORT MATILDA",
            "state": "PA",
            "postal_code": "168707153",
            "telephone_number": "814-272-7100",
            "fax_number": "814-272-6519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIETO YANES",
        "first_name": "LISDEYMI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-10",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA066134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Matilda, PA

Sources for this page

Verify at the official NPI Registry.