Individual provider Active NPI

Fanny Estela Espinal, M.D.

  • Pediatrics Physician
  • York, PA
National Provider Identifier
1992851554
Registry record updated Jun 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD430514 Issued in PA
Practice address
2050 S Queen St
Ste 100
York, PA 17403-4829
Phone
(717) 812-4240
Fax
(717) 848-5520
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD430514 PA Primary

Addresses

Primary practice location

2050 S Queen St
Ste 100
York, PA 17403-4829

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 812-4240

Other identifiers 5

IdentifierTypeStateIssuer
1938014OtherPAHIGHMARK BLUE SHIELD
30123099 - DOVEROtherPAAMERIHEALTH MERCY - WMG
418791OtherPAUPMC
P008312OtherPAGATEWAY
30123100 - YORKOtherPAAMERIHEALTH MERCY - WMG

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120919000065 PA Practitioner - Pediatric Medicine 3779551254 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD430514PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Oct 8, 2012 Accepting new patients
Wellspan Medical Group CurrentSince Oct 8, 2012 Accepting new patients
Wellspan Medical Group Current Accepting new patients

Locations

2050 S Queen St
#100
York, PA 17403
Phone (717) 812-4240

4020 Carlisle Rd
York, PA 17315
Phone (717) 812-4240

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

1600 S George St
York, PA 17403
Phone (717) 848-3615

Interoperability endpoints

  • Direct secure messaging: fespinal13987@wellspan.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1992851554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-812-4240",
            "fax_number": "717-848-5520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 S QUEEN ST",
            "address_2": "STE 100",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174034829",
            "telephone_number": "717-812-4240",
            "fax_number": "717-848-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPINAL",
        "first_name": "FANNY",
        "middle_name": "ESTELA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD430514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1938014",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY - WMG",
            "identifier": "30123099 - DOVER",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC",
            "identifier": "418791",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "P008312",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY - WMG",
            "identifier": "30123100 - YORK",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.