PENN STATE HEALTH COMMUNITY MEDICAL GROUP, LLC (NPI# 1861988644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861988644 |
| Entity Type | Organization |
| Organization Name | PENN STATE HEALTH COMMUNITY MEDICAL GROUP, LLC |
| Other Organization Name | PENN STATE HEALTH MEDICAL GROUP-ANDREWS PATEL HEMATOLOGY/ONCOLOGY |
| Practice Address |
3912 Trindle Rd Camp Hill PA 17011-4246 |
| Mailing Address |
90 Hope Dr # Mca410 Hershey PA 17033-2036 |
| Practice Telephone | 7177618740 |
| Practice Fax Number | 7177618792 |
| Mailing Telephone | 7175311159 |
| Mailing Fax Number | 7175310119 |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2019-04-03 |
| Authorized Official Name | STEPHEN MASSINI (EXECUTIVE VICE PRES, CFO) |
| Authorized Official Telephone | 7175316614 |
| Is Organization Subpart | Y |
| Parent Organization Name | PENN STATE HEALTH COMMUNITY MEDICAL GROUP, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 291U00000X | Clinical Medical Laboratory | Laboratories | ||
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Penn State Health Medical Group-Andrews Patel Hematology/Oncology | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4518 Union Deposit Rd, Harrisburg, PA 171112921 | 7175261030 | 7175261032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891394441 | Penn State Health Community Medical Group, LLC | Physical Therapist | 1800 Center St Ste 1a110, Camp Hill, PA 17011-1702 | 2020-10-23 |
| 1730607755 | Penn State Health Community Medical Group, LLC | Internal Medicine | 233 College Ave Ste 303, Lancaster, PA 17603-3384 | 2017-08-30 |
| 1750373965 | Penn State Health Community Medical Group, LLC | Non-Pharmacy Dispensing Site | 3912 Trindle Rd, Camp Hill, PA 17011-4246 | 2005-08-16 |
| 1801433149 | Penn State Health Community Medical Group, LLC | Internal Medicine | 50 N 12th St, Lemoyne, PA 17043-1440 | 2019-12-05 |
| 1457824013 | Penn State Health Community Medical Group, LLC | Radiology | 4520 Union Deposit Rd, Harrisburg, PA 17111-2910 | 2019-01-07 |
| 1609347152 | Penn State Health Community Medical Group, LLC | Pediatrics | 655 Walnut St, West Reading, PA 19611-1242 | 2018-12-10 |
| 1952897738 | Penn State Health Community Medical Group, LLC | Family Medicine | 5 S Centre Ave, Leesport, PA 19533 | 2018-07-05 |
| 1568976496 | Penn State Health Community Medical Group, LLC | Non-Pharmacy Dispensing Site | 4518 Union Deposit Rd, Harrisburg, PA 17111-2921 | 2017-11-30 |
| 1972032761 | Penn State Health Community Medical Group, LLC | Dietitian, Registered | 2301 Columbia Ave, Lancaster, PA 17603-4154 | 2017-06-06 |
| Street Address |
3912 TRINDLE RD |
| City | CAMP HILL |
| State | PA |
| Zip Code | 17011-4246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750373965 | Penn State Health Community Medical Group, LLC | Non-Pharmacy Dispensing Site | 3912 Trindle Rd, Camp Hill, PA 17011-4246 | 2005-08-16 |
| 1629454475 | Kathleen L Meyer | Nurse Practitioner | 3912 Trindle Rd, Camp Hill, PA 17011 | 2015-08-04 |
| 1679903611 | Elizabeth Mary Smith | Physician Assistant | 3912 Trindle Rd, Camp Hill, PA 17011-4246 | 2013-11-12 |
| 1013259985 | Kathleen Joy Eisemann Yesavage | Nurse Practitioner | 3912 Trindle Rd, Camp Hill, PA 17011-4246 | 2013-03-19 |
| 1821244773 | Saritha Ravella | Internal Medicine | 3912 Trindle Rd, Camp Hill, PA 17011-4246 | 2008-08-12 |
| 1922260504 | Yang Liu | Internal Medicine | 3912 Trindle Rd, Camp Hill, PA 17011-4246 | 2008-06-25 |
| 1689855959 | Mona Patel | Physician Assistant | 3912 Trindle Rd, Camp Hill, PA 17011-4246 | 2007-11-15 |
| 1902098544 | Jihua Cheng | Internal Medicine | 3912 Trindle Rd, Camp Hill, PA 17011-4246 | 2007-08-17 |
| 1477760403 | Kumudini Rao | Internal Medicine | 3912 Trindle Rd, Camp Hill, PA 17011-4246 | 2007-05-17 |
| 1902854904 | Rajesh Surapaneni | Internal Medicine | 3912 Trindle Rd, Camp Hill, PA 17011-4246 | 2006-05-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790241628 | Harrisburg Home Care | Home Health | 1713 Hammel Road, R2, Harrisburg, PA 17011 | 2019-02-15 |
| 1427540269 | Eldercare Solutions LLC | Adult Companion | 1926 Market Street, Camp Hill, PA 17011 | 2018-06-06 |
| 1538680244 | Edward Joseph Hilton | Dentist | 3412 Trindle Road, Camp Hill, PA 17011 | 2017-07-03 |
| 1639609696 | Alicia Taylor Brustein | Physician Assistant | 425 North 21st Street, Suite 405, Camp Hill, PA 17011 | 2017-06-13 |
| 1285166843 | Betsy Earnest, Lpc, LLC | Counselor | 1509 Cedar Cliff Drive, Suite 4, Camp Hill, PA 17011 | 2017-03-31 |
| 1962852368 | Angela Antonia Debo | Family Medicine | 3025 Market Street, Entrance B, Camp Hill, PA 17011 | 2016-06-16 |
| 1033567839 | Timothy Zack Day | Physician Assistant | 897 Poplar Rd, Camp Hill, PA 17011 | 2016-06-02 |
| 1962864892 | Tracy Byra | Registered Nurse | 15 Scarsdale Drive, Camp Hill, PA 17011 | 2016-03-21 |
| 1245634138 | Charlotte Diane Hain | Psychologist | 781 Poplar Church Road, Camp Hill, PA 17011 | 2014-10-21 |
| 1205276805 | Isaac S Chiang | Optometrist | South 32nd Street & Trindle Rd, Camp Hill, PA 17011 | 2013-06-27 |
| Find all providers in zip 17011 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356333751 | Mary A. Simmonds | Internal Medicine | 3912 Trindle Road, Camp Hill, PA 17011-4246 | 2005-08-22 |
| 1629071428 | Alfred R Leal | Internal Medicine | 101 Erford Rd, Suite 101, Camp Hill, PA 17011-1802 | 2005-05-24 |
| 1922260504 | Yang Liu | Internal Medicine | 3912 Trindle Rd, Camp Hill, PA 17011-4246 | 2008-06-25 |
| 1790970069 | Lily H. Shah | Internal Medicine | 3912 Trindle Road, Camp Hill, PA 17011-4246 | 2007-09-10 |
| 1477760403 | Kumudini Rao | Internal Medicine | 3912 Trindle Rd, Camp Hill, PA 17011-4246 | 2007-05-17 |
| 1548487085 | Joshua L. Shipley | Internal Medicine | 3912 Trindle Road, Camp Hill, PA 17011-4246 | 2007-04-19 |
| 1821134404 | Scott C Felter I | Internal Medicine | 101 Erford Rd, Suite 101, Camp Hill, PA 17011-1802 | 2007-01-30 |
| 1902854904 | Rajesh Surapaneni | Internal Medicine | 3912 Trindle Rd, Camp Hill, PA 17011-4246 | 2006-05-04 |
| 1912969585 | Charles William Reninger IIi | Internal Medicine | 101 Erford Rd, Suite 101, Camp Hill, PA 17011-1802 | 2006-04-06 |
| 1962462366 | Hematology & Oncology Consultants of Pennsylvania, P.C. | Internal Medicine | 101 Erford Rd, Suite 101, Camp Hill, PA 17011-1802 | 2006-03-28 |
| Find all providers in CAMP HILL | ||||
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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.