SUSQUEHANNA PHYSICIAN SERVICES (NPI# 1346263266) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346263266 |
| Entity Type | Organization |
| Organization Name | SUSQUEHANNA PHYSICIAN SERVICES |
| Other Organization Name | SUSQUEHANNA HEALTH MEDICAL GROUP |
| Practice Address |
1705 Warren Ave Suite 204-205 Williamsport PA 17701-2647 |
| Mailing Address |
1201 Grampian Blvd Williamsport PA 17701-1900 |
| Practice Telephone | 5703207474 |
| Practice Fax Number | 5703207479 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | MS. MELISSA DAVIS (VP/COO) |
| Authorized Official Telephone | 5703207696 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 231H00000X | Audiologist | Speech, Language and Hearing Service Providers | ||
| N | 237600000X | Audiologist-Hearing Aid Fitter | Speech, Language and Hearing Service Providers | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | HIGHMARK BLUE SHIELD | 501737 | 01 |
| PA | 0017300760202 | 05 | |
| PA | 0017300760201 | 05 |
| Other Name | Type Code |
|---|---|
| Susquehanna Health Medical Group | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6850 Lows Rd Ste 320, Bloomsburg, PA 178158708 | 5703874368 |
| 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 |
1705 WARREN AVE SUITE 204-205 |
| City | WILLIAMSPORT |
| State | PA |
| Zip Code | 17701-2647 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992702682 | Kenneth Robert Durrwachter | Family Medicine | 1705 Warren Ave, Suite 208, Williamsport, PA 17701-2647 | 2005-07-07 |
| 1043862824 | Karen A Armson | Physical Therapist | 1705 Warren Ave, Williamsport, PA 17701-2647 | 2019-07-12 |
| 1558913202 | Shari Mcelwain Berthold | Physical Therapist | 1705 Warren Ave, Williamsport, PA 17701-2647 | 2019-07-12 |
| 1740832609 | Joan Winslow | Physical Therapist | 1705 Warren Ave, Williamsport, PA 17701-2647 | 2019-07-11 |
| 1184276065 | Kristen Durrwachter | Physical Medicine & Rehabilitation | 1705 Warren Ave, Williamsport, PA 17701-2647 | 2019-07-11 |
| 1538563804 | Amber Snyder | Specialist/Technologist, Other | 1705 Warren Ave, Suite 103, Williamsport, PA 17701-2647 | 2014-10-15 |
| 1821406547 | Crystal Jean Loose | Physician Assistant | 1705 Warren Ave, Suite 101-103, Williamsport, PA 17701-2647 | 2014-07-25 |
| 1467865204 | Erin Foley | Physician Assistant | 1705 Warren Ave, Suite 101-103, Williamsport, PA 17701-2647 | 2014-06-10 |
| 1215361639 | Megan Ann Sechrist | Physician Assistant | 1705 Warren Ave, Suite 204-205, Williamsport, PA 17701-2647 | 2013-08-22 |
| 1598198525 | Kelly Douglass | Nurse Practitioner | 1705 Warren Ave, Suite 303, Williamsport, PA 17701-2665 | 2013-08-13 |
| 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 | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174968382 | Kathryn Marie Morton | Otolaryngology | 1705 Warren Ave Ste 204-205, Williamsport, PA 17701-2647 | 2013-05-01 |
| 1538314604 | Joel Oliver D'hue | Otolaryngology | 1705 Warren Ave, Suite 205, Williamsport, PA 17701-2647 | 2008-11-17 |
| 1477578433 | Joseph Hilstrom Baker | Otolaryngology | 1705 Warren Ave, Suite 205, Williamsport, PA 17701-2647 | 2006-07-12 |
| 1669437943 | Phillip K. Pellitteri | Otolaryngology | 1705 Warren Ave Ste 204-205, Williamsport, PA 17701-2647 | 2006-04-19 |
| 1376511386 | William Walter Banks | Otolaryngology | 1705 Warren Ave, Suite 205, Williamsport, PA 17701-2647 | 2006-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043877319 | Health Services of Clarion, Inc. | Otolaryngology | 30 Pinnacle Dr Ste 301, Clarion, PA 16214-3800 | 2019-05-22 |
| 1134680747 | Providence Ear Nose & Throat Associates Inc | Otolaryngology | Riddle Mem. Hosp.- Outpt. Pav., 1098 W. Baltimore Pk. Ste 3406, Media, PA 19063-5139 | 2019-03-27 |
| 1619437654 | Providence Ear Nose & Throat Associates Inc | Otolaryngology | 500 Evergreen Dr Ste 18, Glen Mills, PA 19342-1032 | 2019-03-25 |
| 1659844264 | David C Hughes | Otolaryngology | 1047 Lilac St, Indiana, PA 15701-2459 | 2019-01-07 |
| 1790278372 | Vishaal Patel | Otolaryngology | 3440 N Broad St # 300, Philadelphia, PA 19140-5104 | 2018-06-08 |
| 1710409594 | Philippe Lavigne | Otolaryngology | 200 Lothrop St Ste 300, Pittsburgh, PA 15213-2536 | 2017-07-12 |
| 1033630892 | Jessica Anne Tang | Otolaryngology | 3440 North Broad Street, Kresge West #300, Philadelphia, PA 19140 | 2017-07-03 |
| 1417313255 | Robert Guelcher | Otolaryngology | 521 Montmarc Blvd, Erie, PA 16504-2611 | 2016-01-09 |
| 1689057804 | Rui Jun Lin | Otolaryngology | 2533b Wharton St, Pittsburgh, PA 15203-5103 | 2015-07-07 |
| 1861870511 | Giuseppe V Staltari | Otolaryngology | 203 Lothrup Street, Eye and Ear Building, Suite 500, Pittsburgh, PA 15213-2536 | 2015-05-14 |
| 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.