WELLSPAN MEDICAL GROUP (NPI# 1649348525) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649348525 |
| Entity Type | Organization |
| Organization Name | WELLSPAN MEDICAL GROUP |
| Other Organization Name | WELLSPAN FAMILY MEDICINE - EAST BERLIN |
| Practice Address |
105 4th St # 727 East Berlin PA 17316-9638 |
| Mailing Address |
1803 Mount Rose Ave Suite B3 York PA 17403-3051 |
| Practice Telephone | 7178124900 |
| Practice Fax Number | 7172597262 |
| Mailing Telephone | 7178511405 |
| Mailing Fax Number | 7172597262 |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2019-07-15 |
| Authorized Official Name | MS. JULIANN DIAZ (CREDENTIALING SUPERVISOR) |
| Authorized Official Telephone | 7178511405 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | AMERIHEALTH MERCY | 1142342 | 01 |
| PA | UNISON | 82212 | 01 |
| PA | HIGHMARK BLUE SHIELD | 597344 | 01 |
| PA | CAPITAL BLUE CROSS | 02293300 | 01 |
| PA | RAILROAD MEDICARE | CA3246 | 01 |
| PA | JOHN HOPKINS | 800174 | 01 |
| PA | AMERIHEALTH 65 PA | 0756905001 | 01 |
| PA | 1007721360095 | 05 | |
| PA | AETNA | 5388041 | 01 |
| MD | CAREFIRST MD BCBS | KX10 | 01 |
| PA | GEISINGER | S1ER | 01 |
| PA | GATEWAY | 1519296 | 01 |
| Other Name | Type Code |
|---|---|
| WELLSPAN FAMILY MEDICINE - EAST BERLIN | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962980730 | Wellspan Medical Group | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 40 V Twin Dr Ste 102, Gettysburg, PA 17325-7878 | 2018-08-02 |
| 1245490515 | Wellspan Medical Group | Surgery | 50 Wyntre Brooke Dr, York, PA 17403-4535 | 2008-06-11 |
| 1184784704 | Wellspan Medical Group | Internal Medicine | 40 V Twin Dr Ste 204, Gettysburg, PA 17325-7878 | 2006-12-12 |
| 1801954276 | Wellspan Medical Group | Internal Medicine | 296 St. Charles Way, York, PA 17402-4648 | 2006-12-05 |
| 1790853695 | Wellspan Medical Group | Family Medicine | 4910a Fairfield Road, Fairfield, PA 17320-9510 | 2006-12-01 |
| 1801982426 | Wellspan Medical Group | Pain Medicine | 140 Pine Grove Commons, York, PA 17403-5151 | 2006-10-04 |
| 1194819193 | Wellspan Medical Group | Neurological Surgery | 228 Saint Charles Way, York, PA 17402-4644 | 2006-10-03 |
| 1740236900 | Wellspan Medical Group | Orthopaedic Surgery | 18 Deatrick Drive, Gettysburg, PA 17325-6958 | 2006-05-26 |
| 1215994934 | Wellspan Medical Group | Family Medicine | 924 Colonial Ave Ste B, York, PA 17403-3450 | 2006-04-27 |
| 1740249325 | Wellspan Medical Group | Counselor | 3550 Concord Road, York, PA 17402 | 2006-03-21 |
| Street Address |
105 4TH ST # 727 |
| City | EAST BERLIN |
| State | PA |
| Zip Code | 17316-9638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053558098 | Jose Acerimo Garcia | Family Medicine | 470 Bermudian Creek Road, East Berlin, PA 17316 | 2009-01-13 |
| 1114956018 | Catherine Booth Heilman | Family Medicine | 105 Fourth Street, East Berlin, PA 17316 | 2006-07-02 |
| 1417956244 | Northeast Adams Fire & Ems | Ambulance | 101 E Locust St, East Berlin, PA 17316 | 2005-07-14 |
| 1487171666 | Manotte Etienne | Nurse Practitioner | 312 Harrisburg St, East Berlin, PA 17316 | 2017-08-28 |
| 1508852120 | Choice Critical Care Rx LLC | Pharmacy | 330 North Ave, East Berlin, PA 17316-7831 | 2005-09-20 |
| 1538716824 | Amy Messinger | Registered Nurse | 295 Jessica Dr, East Berlin, PA 17316-8310 | 2019-08-21 |
| 1023264843 | Jason Brian Orlak | Hearing Instrument Specialist | 193 Kimberly Ln, East Berlin, PA 17316-8314 | 2008-08-12 |
| 1831161389 | Stanley Joseph Falenski | Pharmacist | 30 Primrose Ln, East Berlin, PA 17316-8505 | 2006-02-07 |
| 1619437951 | Joseph Zalakar | Pharmacist | 30 Primrose Ln, East Berlin, PA 17316-8505 | 2019-03-22 |
| 1033689450 | Olivia Hines | Pharmacist | 30 Primrose Ln, East Berlin, PA 17316-8505 | 2018-11-28 |
| Find all providers in zip 17316 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053558098 | Jose Acerimo Garcia | Family Medicine | 470 Bermudian Creek Road, East Berlin, PA 17316 | 2009-01-13 |
| 1114956018 | Catherine Booth Heilman | Family Medicine | 105 Fourth Street, East Berlin, PA 17316 | 2006-07-02 |
| 1639176449 | Michael A Zittle | Family Medicine | 312 Harrisburg St, East Berlin, PA 17316-9505 | 2005-07-07 |
| 1508210717 | Stephanie Jane Ellwood | Family Medicine | 105 4th St, East Berlin, PA 17316-9638 | 2016-04-14 |
| 1902164080 | Lauren Michelle Cashman | Family Medicine | 105 4th St, East Berlin, PA 17316-9638 | 2012-04-26 |
| 1841582921 | Annie Melinda Harberger | Family Medicine | 105 4th St, East Berlin, PA 17316-9638 | 2011-05-09 |
| 1891085254 | Amanda Lindsay Keller-smith | Family Medicine | 105 4th St, East Berlin, PA 17316-9638 | 2011-04-19 |
| 1578895017 | Rachel Benelli Markey | Family Medicine | 105 4th St, East Berlin, PA 17316-9638 | 2010-02-09 |
| 1528090321 | Wynne Ann Hoffacker | Family Medicine | 105 4th St, East Berlin, PA 17316-9638 | 2006-07-06 |
| 1780614214 | Michael Eugene Brown | Family Medicine | 105 4th St, East Berlin, PA 17316-9638 | 2006-07-03 |
| Find all providers in EAST BERLIN | ||||
| City | EAST BERLIN |
| Zip Code | 17316 |
Please comment or provide details below to improve the information on WELLSPAN MEDICAL GROUP.
| 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.