SUSQUEHANNA PHYSICIAN SERVICES


Address: 700 High Street, Williamsport, PA 17701-3198
Phone: 5703213580

SUSQUEHANNA PHYSICIAN SERVICES (NPI# 1083677868) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1083677868
Entity Type Organization
Organization Name SUSQUEHANNA PHYSICIAN SERVICES
Other Organization Name SUSQUEHANNA HEALTH MEDICAL GROUP
Practice Address 700 High Street
Williamsport
PA 17701-3198
Mailing Address 1201 Grampian Blvd
Williamsport
PA 17701-1900
Practice Telephone 5703213580
Practice Fax Number 5703213581
Enumeration Date 2006-04-11
Last Update Date 2015-11-02
Authorized Official Name MS. MELISSA DAVIS (VP/COO)
Authorized Official Telephone 5703207696
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207RC0200X Internal Medicine
Specialization: Critical Care Medicine
Allopathic & Osteopathic Physicians
N 207RS0012X Internal Medicine
Specialization: Sleep Medicine
Allopathic & Osteopathic Physicians
N 363L00000X Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers
Y 207RP1001X Internal Medicine
Specialization: Pulmonary Disease
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
PA 0017300760181 05
PA HIGHMARK BLUE SHIELD 1927136 01

Other Provider/Organization Names

Other Name Type Code
Susquehanna Health Medical Group Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1033345533 Susquehanna Physician Services Nurse Practitioner 10 Shady Lane, Suite 201, Muncy, PA 17756-8807 2009-06-10
1477793172 Susquehanna Physician Services Physician Assistant 1201 Grampian Blvd Ste 1a, Williamsport, PA 17701-1965 2009-02-20
1780603837 Susquehanna Physician Services Obstetrics & Gynecology 2134 W 4th St, Williamsport, PA 17701-4344 2006-07-19
1467453878 Susquehanna Physician Services Clinic/Center 1112 Grampian Blvd, Williamsport, PA 17701-1909 2005-08-09
1578164943 Susquehanna Physician Services Podiatrist 2370 Old Turnpike Rd Ste 4, Lewisburg, PA 17837-6567 2020-11-03
1982205472 Susquehanna Physician Services Clinic/Center 416 S Main St Ste 1, Mansfield, PA 16933-1510 2020-11-03
1962018135 Susquehanna Physician Services Family Medicine 700 High St Fl 9, Williamsport, PA 17701-3100 2020-09-22
1992359798 Susquehanna Physician Services Emergency Medicine 700 High St, Williamsport, PA 17701-3100 2019-07-30
1689905606 Susquehanna Physician Services Nurse Practitioner 777 Rural Ave, Williamsport, PA 17701-3109 2010-01-15
1134455967 Susquehanna Physician Services Physician Assistant 1100 Grampian Blvd, Williamsport, PA 17701-1909 2009-10-29

Office Location

Street Address 700 HIGH STREET
City WILLIAMSPORT
State PA
Zip Code 17701-3198

Providers in the same location

NPI Name Taxonomy Address Enumeration
1679127211 Jessica Lyn Percoco Registered Nurse 700 High Street, Williamsport, PA 17701 2019-08-01
1619440971 Debra Kay Canellos Nurse Practitioner 700 High Street, Williamsport, PA 17701-3198 2019-01-09
1013351378 Timothy Edward Wirth Pharmacist 700 High Street, Pharmacy Department, Williamsport, PA 17701 2013-04-17
1760730824 Alana E John Internal Medicine 700 High Street, Williamsport, PA 17701-3198 2012-08-21
1639432628 Ashley Nichole Pence Pediatrics 700 High Street, Williamsport, PA 17701-3198 2012-06-25
1912266685 Brent M Carpenter Nurse Anesthetist, Certified Registered 700 High Street, Williamsport, PA 17701-3198 2012-05-15
1235366857 Susquehanna Physician Services Physician Assistant 700 High Street, Williamsport, PA 17701-3198 2009-06-22
1518113570 Marissa Lara Ambron Internal Medicine 700 High Street, Williamsport, PA 17701-3198 2008-08-11
1497962286 Puneet Gupta Internal Medicine 700 High Street, Williamsport, PA 17701-3198 2007-05-17
1285719559 Upmc Williamsport Clinic/Center 700 High Street, Williamsport, PA 17701-3198 2006-10-26
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1184267809 Charlene Angella Pitter Nurse Practitioner 170 Warren Ave, Williamsport, PA 17701 2019-10-25
1396395299 Susan E Fetzer Occupational Therapy Assistant Upmc Susquehanna,625 West Edwin Street, Williamsport, PA 17701 2019-09-13
1184280984 Craig Andrew Tuller Student in an Organized Health Care Education/Training Program Williamsport Family Medicine Residency, 740 High Street, Suite 4001, Williamsport, PA 17701 2019-05-16
1760048045 Michael Harvey Student in an Organized Health Care Education/Training Program 740 High St. Suite 4001, Williamsport, PA 17701 2019-05-13
1275196008 Olivia Fladmark Student in an Organized Health Care Education/Training Program Williamsport Family Medicine Residency 740 High St, Suite 4001, Williamsport, PA 17701 2019-04-17
1528551231 Mark Hampton Chiropractic Inc. Durable Medical Equipment & Medical Supplies 1111 East 3rd Street, Williamsport, PA 17701 2018-06-08
1548710882 Central Pennsylvania Rehabilitation Medicine, Inc Physical Medicine & Rehabilitation 460 River Ave Ste 1, Williamsport, PA 17701 2016-10-11
1376096784 Christine Kessler Physician Assistant One College Ave, Penna. College of Tech, Pa Program Dif 123, Williamsport, PA 17701 2016-08-02
1629440276 Matthew Ray Rebuck Specialist/Technologist 220 N Reach Rd, Williamsport, PA 17701 2015-10-22
1508237223 Neihl Williamson Physician Assistant 1205 Grampian Blvd Ste 3c, Williamsport, PA 17701 2015-10-08
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Taxonomy Information

Taxonomy Code 207RP1001X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Pulmonary Disease

Taxonomy Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1114274065 Muhammad Kashif Internal Medicine 700 High St, Williamsport, PA 17701-3100 2012-08-09

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1376171264 Jamie Shawn Shatzman Internal Medicine 25 Harrison Dr, Newtown Square, PA 19073-1420 2020-03-28
1033746813 Advanced Pulmonary Specialists Internal Medicine 846 Bank St, Beaver, PA 15009-2602 2020-03-24
1881229417 Mark Arthur Stypula Internal Medicine 848 Arbordale Ln, Wexford, PA 15090-7439 2020-03-04
1063076289 Lung Health Services PC Internal Medicine 1240 South Broad Street, Suite 230, Lansdale, PA 19446 2019-04-23
1023595667 Pulmonary Consultants Inc. Internal Medicine 1 Medical Center Blvd Ste 422, Chester, PA 19013-3902 2018-07-26
1013437250 Pinnacle Health Regional Physicians Internal Medicine 1533 Commerce Ave Ste 3, Carlisle, PA 17015-9128 2017-06-20
1346610805 Saint Vincent Medical Education and Research Institute Inc. Internal Medicine 145 West 24th Street, 302a, Erie, PA 16544-0002 2015-09-28
1831573146 Meadville Physician Services Internal Medicine 751 Liberty St Ste G-19, Meadville, PA 16335-2559 2015-07-16
1700260163 Richard Kenneth Murray Internal Medicine 809 N Mount Pleasant Rd, Philadelphia, PA 19119-3303 2015-07-16
1518362359 Grand View Hospital Internal Medicine 817 Lawn Ave Ste 4, Sellersville, PA 18960 2014-10-22
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Competitor

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City WILLIAMSPORT
Zip Code 17701

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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