SUSQUEHANNA PHYSICIAN SERVICES (NPI# 1689905606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689905606 |
| Entity Type | Organization |
| Organization Name | SUSQUEHANNA PHYSICIAN SERVICES |
| Practice Address |
777 Rural Ave Williamsport PA 17701-3109 |
| Mailing Address |
1201 Grampian Blvd Po Box 3127 Williamsport PA 17701-0127 |
| Practice Telephone | 5703275566 |
| Practice Fax Number | 5703274755 |
| Enumeration Date | 2010-01-15 |
| Last Update Date | 2010-01-15 |
| 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 |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers |
| 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 |
| 1134455967 | Susquehanna Physician Services | Physician Assistant | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2009-10-29 |
| Street Address |
777 RURAL AVE |
| City | WILLIAMSPORT |
| State | PA |
| Zip Code | 17701-3109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992791057 | Susquehanna Cardiology Associates, P. C. | Internal Medicine | 777 Rural Ave, Williamsport, PA 17701-3109 | 2005-09-23 |
| 1679906515 | Michele Lynn Snyder | Nurse Anesthetist, Certified Registered | 777 Rural Ave, Williamsport, PA 17701-3109 | 2013-08-14 |
| 1083908339 | Heidi Ault | Pharmacist | 777 Rural Ave, Williamsport, PA 17701-3109 | 2011-06-03 |
| 1104115526 | Robert B Zaleski | Pharmacist | 777 Rural Ave, Williamsport, PA 17701-3109 | 2011-04-06 |
| 1164734810 | David Alan Bortel | Nurse Anesthetist, Certified Registered | 777 Rural Ave, Williamsport, PA 17701-3109 | 2010-07-10 |
| 1386892669 | Brian James Heintzelman | Pharmacist | 777 Rural Ave, Sl2 East, Williamsport, PA 17701-3109 | 2008-08-29 |
| 1093903791 | Susquehanna Physician Services | Nurse Practitioner | 777 Rural Ave, Williamsport, PA 17701-3145 | 2007-10-09 |
| 1396862900 | Okwudili Francis Chukwuani | Surgery | 777 Rural Ave, Williamsport, PA 17701-3145 | 2007-03-26 |
| 1063597334 | Upmc Williamsport | Clinic/Center | 777 Rural Ave, Williamsport, PA 17701-3109 | 2006-10-26 |
| 1093890360 | Upmc Williamsport | Ambulance | 777 Rural Ave, Williamsport, PA 17701-3109 | 2006-10-26 |
| 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 | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902804339 | Jennifer Ellyn Bayer | Nurse Practitioner | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2005-07-11 |
| 1528319555 | Diane Louise Sholder | Nurse Practitioner | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2012-10-01 |
| 1962769851 | Diane Kay Daddario | Nurse Practitioner | 1100 Grampian Blvd, Williamsport, PA 17701-1907 | 2012-04-16 |
| 1780963082 | Rose Noviello Czap | Nurse Practitioner | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2011-08-04 |
| 1639409113 | Amy Lynne Grimes | Nurse Practitioner | 700 High St, Williamsport, PA 17701-3198 | 2010-01-06 |
| 1992955975 | Stephanie Deviney | Nurse Practitioner | 740 High St, Suite 2001, Williamsport, PA 17701-3102 | 2008-09-25 |
| 1326078536 | Susquehanna Physician Services | Nurse Practitioner | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2006-07-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669072641 | Pinnacle Health Medical Services | Nurse Practitioner | 250 Fame Ave Ste 201, Hanover, PA 17331-1587 | 2020-10-28 |
| 1265044093 | Michelle Lynn Hurst | Nurse Practitioner | 1590 Medical Dr Ste A, Pottstown, PA 19464-3247 | 2020-08-21 |
| 1255942272 | Jessica Ann Joy | Nurse Practitioner | 200 Lothrop Street Muh E804, Pittsburgh, PA 15213 | 2020-08-13 |
| 1437768413 | Stephanie Marie Lesseski | Nurse Practitioner | 2014 Creekside Dr, Edinboro, PA 16412-1458 | 2020-07-27 |
| 1588272959 | Elaine Michele Matisko | Nurse Practitioner | 56 Dorthea Street Ext, Houtzdale, PA 16651-8607 | 2020-07-21 |
| 1275155012 | Jamie Lee Auyeung | Nurse Practitioner | 2413 Lytle Rd, Bethel Park, PA 15102-2790 | 2020-05-14 |
| 1730715822 | Suzette Jones | Nurse Practitioner | Mid-state Occupational Health Services, Inc., 1000 Meade Street, Dunmore, PA 18512 | 2020-03-20 |
| 1841834710 | Joseph Mascaro | Nurse Practitioner | 125 S 9th St Ste 1005, Philadelphia, PA 19107-5123 | 2019-11-04 |
| 1477100311 | Larissa Marie Glowinski | Nurse Practitioner | 502 Vna Rd, East Stroudsburg, PA 18301-7965 | 2019-08-26 |
| 1295382232 | Marthe Adler | Nurse Practitioner | 300b Lawrence Dr, West Chester, PA 19380-4289 | 2019-08-23 |
| 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.