SUSQUEHANNA PHYSICIAN SERVICES (NPI# 1619996733) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619996733 |
| Entity Type | Organization |
| Organization Name | SUSQUEHANNA PHYSICIAN SERVICES |
| Other Organization Name | SPS-PLASTIC SURGERY |
| Practice Address |
1201 Grampian Blvd Suite 1b Williamsport PA 17701-1900 |
| Mailing Address |
1205 Grampian Blvd Po Box 3127 Williamsport PA 17701-1978 |
| Practice Telephone | 5703207570 |
| Practice Fax Number | 5703207571 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2007-10-18 |
| Authorized Official Name | MR. CHARLES SANTANGELO (EXECUTIVE VP/CFO) |
| Authorized Official Telephone | 5703213171 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 208200000X | Plastic Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | HIGHMARK BLUE SHIELD | 1743458 | 01 |
| PA | FIRST PRIORITY HEALTH | 221536 | 01 |
| Other Name | Type Code |
|---|---|
| SPS-Plastic Surgery | Other Name - Individual/Organization |
| 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 |
| 1083677868 | Susquehanna Physician Services | Internal Medicine | 700 High Street, Williamsport, PA 17701-3198 | 2006-04-11 |
| 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 |
| Street Address |
1201 GRAMPIAN BLVD SUITE 1B |
| City | WILLIAMSPORT |
| State | PA |
| Zip Code | 17701-1900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942293287 | Joanne Marie Lalli | Internal Medicine | 1201 Grampian Blvd, Ste 2d, Williamsport, PA 17701 | 2005-08-23 |
| 1205436987 | Nicholas Anthony Inverso II | Pharmacist | 1201 Grampian Blvd, Williamsport, PA 17701-1900 | 2020-10-30 |
| 1881193217 | Amanda Shadle | Specialist/Technologist | 1201 Grampian Blvd, Williamsport, PA 17701-1900 | 2018-02-12 |
| 1629528385 | Brian Kramer Jr. | Physician Assistant | 1201 Grampian Blvd, Suite 1a, Williamsport, PA 17701-1900 | 2016-10-06 |
| 1326498726 | Morgan Rogers | Family Medicine | 1201 Grampian Blvd, Suite 3c, Williamsport, PA 17701-1970 | 2016-06-16 |
| 1528424975 | Ncpdc Kidney Center LLC | Clinic/Center | 1201 Grampian Blvd, Williamsport, PA 17701-1900 | 2016-01-14 |
| 1710369467 | North Central Pennsylvania Dialysis Clincs LLC | Clinic/Center | 1201 Grampian Blvd, Williamsport, PA 17701-1900 | 2015-06-18 |
| 1124315320 | Christine Kara Nolan | Podiatrist | 1201 Grampian Blvd, Suite 2f, Williamsport, PA 17701-1965 | 2011-07-08 |
| 1013228857 | Steven Michael Hawley | Podiatrist | 1201 Grampian Blvd, Suite 2f, Williamsport, PA 17701-1965 | 2010-06-26 |
| 1578791497 | Zachary Thomas Ritter | Podiatrist | 1201 Grampian Blvd, Suite 2f, Williamsport, PA 17701-1965 | 2009-06-30 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 17701 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457580102 | Nathalie Lavallee | Plastic Surgery | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2009-07-02 |
| 1881622868 | Susquehanna Physician Services | Plastic Surgery | 740 High St, Suite 1003, Williamsport, PA 17701-3100 | 2006-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588298418 | Grunwaldt Falbo Pllc | Plastic Surgery | 873 Bebout Rd, Venetia, PA 15367-1215 | 2020-03-01 |
| 1528606654 | Everest Medspa LLC | Plastic Surgery | 6787 Market St Ste 106, Upper Darby, PA 19082-1848 | 2019-12-19 |
| 1851939771 | Ericka Culp | Plastic Surgery | 5750 Centre Ave Ste 360, Pittsburgh, PA 15206-3761 | 2019-12-11 |
| 1346742871 | Andrea Kristin Chamberlain | Plastic Surgery | 1614 Washington Rd, Pittsburgh, PA 15241-1210 | 2018-02-28 |
| 1205348141 | Kp Aesthetics, LLC. | Plastic Surgery | 4675 W Chester Pike, Newtown Square, PA 19073-2227 | 2017-11-01 |
| 1346765229 | Denise M. Kenna, M.d. | Plastic Surgery | 2350 Freedom Way Ste 107, York, PA 17402-8200 | 2017-08-11 |
| 1467973305 | Hr Physician Services | Plastic Surgery | 3300 Tillman Dr Ste 201, Bensalem, PA 19020-2071 | 2017-06-30 |
| 1598293979 | Andrea Rae Hiller | Plastic Surgery | 500 University Dr # Mch071, Hershey, PA 17033 | 2017-05-30 |
| 1295116473 | Shagun Aggarwal | Plastic Surgery | 3400 Civic Center Blvd Fl 7, Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA 19104-5163 | 2015-06-14 |
| 1598152852 | Brenton Robinson | Plastic Surgery | 3550 Terrace Street Scaife Hall Suite 668, Pittsburgh, PA 15261-5640 | 2015-04-23 |
| Find all providers with the same taxonomy | ||||
| City | WILLIAMSPORT |
| Zip Code | 17701 |
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| 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.