WELLSPAN MEDICAL GROUP (NPI# 1821159021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821159021 |
| Entity Type | Organization |
| Organization Name | WELLSPAN MEDICAL GROUP |
| Other Organization Name | WELLSPAN NEPHROLOGY |
| Practice Address |
380 Saint Charles Way York PA 17402-4647 |
| Mailing Address |
3421 Concord Rd York PA 17402-9001 |
| Practice Telephone | 7178516040 |
| Practice Fax Number | 7178123190 |
| Mailing Telephone | 7178516040 |
| Mailing Fax Number | 7178123190 |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2015-04-15 |
| Authorized Official Name | MS. AMY F WILKINSON (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 7178511405 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1007721360254 | 05 | |
| PA | HIGHMARK BLUES SHIELD | 117038 | 01 |
| PA | AMERIHEALTH MERCY | 20047687 | 01 |
| PA | JOHN HOPKINS | 800174 | 01 |
| PA | GATEWAY | 1548225 | 01 |
| PA | AETNA | 7579839 | 01 |
| PA | CAPITAL BLUE CROSS | 50055987 | 01 |
| MD | CAREFIRST BCBS | 522C | 01 |
| PA | AMERIHEALTH 65PA | 0667146000 | 01 |
| PA | GEISINGER | 340T | 01 |
| PA | RAILROAD MEDICARE | CA3246 | 01 |
| Other Name | Type Code |
|---|---|
| Wellspan Nephrology | 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 |
| 1649348525 | Wellspan Medical Group | Physician Assistant | 105 4th St # 727, East Berlin, PA 17316-9638 | 2006-12-01 |
| 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 |
| Street Address |
380 SAINT CHARLES WAY |
| City | YORK |
| State | PA |
| Zip Code | 17402-4647 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922050079 | Sunita Goyle Ray | Internal Medicine | 380 Saint Charles Way, York, PA 17402-4647 | 2006-05-17 |
| 1528466695 | Suzanne Beck | Nurse Practitioner | 380 Saint Charles Way, York, PA 17402-4647 | 2014-12-05 |
| 1285983684 | Mohamed Anwar Abdus Samad | Internal Medicine | 380 Saint Charles Way, York, PA 17402-4647 | 2012-08-31 |
| 1568751360 | Arul Vigg | Internal Medicine | 380 Saint Charles Way, York, PA 17402-4647 | 2011-04-01 |
| 1326234899 | Sayed Alimuddin Kazi | Internal Medicine | 380 Saint Charles Way, York, PA 17402-4647 | 2007-09-19 |
| 1477769735 | Tariq Nawaz | Internal Medicine | 380 Saint Charles Way, York, PA 17402-4647 | 2007-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265053987 | Hope Renewed Counseling Services LLC | Social Worker | 879 Clare Lane, York, PA 17402 | 2020-05-04 |
| 1912462292 | Andventure, Inc. | Home Health | Andventure, Inc., 3415c Concord Rd., York, PA 17402 | 2019-01-31 |
| 1407327992 | Tariro Manamike | Pharmacist | Weis Markets Pharmacy, 2400 E Market Street, York, PA 17402 | 2018-12-10 |
| 1689120925 | Benjamin Stahle | Emergency Medicine | 70 Locust Grove Road, York, PA 17402 | 2016-08-28 |
| 1275905614 | Ultra Dental I, LLC | Dentist | 233 Pauline Drive, York, PA 17402 | 2015-10-26 |
| 1215323878 | Sonya Maria Korda | Dentist | 332 Shasta Dr., York, PA 17402 | 2015-04-10 |
| 1588909691 | Kimberly Sue Marsico | Counselor | 3110 East Market St, York, PA 17402 | 2012-11-29 |
| 1184995797 | Ivan Lewis Butler | General Practice | 204 St. Charles Way, Unit 364e, York, PA 17402 | 2012-01-13 |
| 1801117783 | Active Life Chiropractic | Chiropractor | 1915 E. Market Street, York, PA 17402 | 2010-06-15 |
| 1578881652 | Oss Orthopaedic Hospital, LLC | General Acute Care Hospital | 1861 Powder Mill Rd., York, PA 17402 | 2010-05-13 |
| Find all providers in zip 17402 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174825707 | Catherine Stehman-breen | Internal Medicine | 5 Meetinghouse Ln, York, ME 03909-1073 | 2010-12-02 |
| 1043265812 | Nephrology Associates of York PC | Internal Medicine | 1920 Queenswood Dr., Suite 200, York, PA 17403 | 2006-05-23 |
| 1922050079 | Sunita Goyle Ray | Internal Medicine | 380 Saint Charles Way, York, PA 17402-4647 | 2006-05-17 |
| 1467455667 | Paul Burnett Schendel | Internal Medicine | 1920 Queenswood Dr, Suite 200, York, PA 17403-4269 | 2005-05-23 |
| 1497006779 | Anil Kumar Nalla | Internal Medicine | 1701 Innovation Dr, York, PA 17408-8815 | 2012-09-26 |
| 1285983684 | Mohamed Anwar Abdus Samad | Internal Medicine | 380 Saint Charles Way, York, PA 17402-4647 | 2012-08-31 |
| 1326234899 | Sayed Alimuddin Kazi | Internal Medicine | 380 Saint Charles Way, York, PA 17402-4647 | 2007-09-19 |
| 1871792960 | Nimrta Ghuman | Internal Medicine | 1920 Queenswood Dr, Suite 200, York, PA 17403-4269 | 2007-07-17 |
| 1699981746 | Tammy J. Miller | Internal Medicine | 1920 Queenswood Dr, Suite 200, York, PA 17403-4269 | 2007-05-15 |
| 1104892223 | Dean H Matsuura | Internal Medicine | 1920 Queenswood Dr, Sutie 200, York, PA 17403-4269 | 2006-02-28 |
| Find all providers in YORK | ||||
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.