SUSQUEHANNA PHYSICIAN SERVICES (NPI# 1962434076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962434076 |
| Entity Type | Organization |
| Organization Name | SUSQUEHANNA PHYSICIAN SERVICES |
| Other Organization Name | SUSQUEHANNA HEALTH MEDICAL GROUP |
| Practice Address |
700 High Street Williamsport PA 17701-3198 |
| Mailing Address |
1201 Grampian Blvd Williamsport PA 17701-1900 |
| Practice Telephone | 5703212400 |
| Practice Fax Number | 5703212496 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2015-11-16 |
| 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 | 207UN0901X |
Nuclear Medicine Specialization: Nuclear Cardiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| Y | 207U00000X | Nuclear Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | HIGHMARK BLUE SHIELD | 887918 | 01 |
| PA | 0017300760185 | 05 |
| Other Name | Type Code |
|---|---|
| Susquehanna Health Medical Group | Doing Business As Name - Organization |
| 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 |
700 HIGH STREET |
| City | WILLIAMSPORT |
| State | PA |
| Zip Code | 17701-3198 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083677868 | Susquehanna Physician Services | Internal Medicine | 700 High Street, Williamsport, PA 17701-3198 | 2006-04-11 |
| 1679127211 | Jessica Lyn Percoco | Registered Nurse | 700 High Street, Williamsport, PA 17701 | 2019-08-01 |
| 1619440971 | Debra Kay Canellos | Nurse Practitioner | 700 High Street, Williamsport, PA 17701-3198 | 2019-01-09 |
| 1013351378 | Timothy Edward Wirth | Pharmacist | 700 High Street, Pharmacy Department, Williamsport, PA 17701 | 2013-04-17 |
| 1760730824 | Alana E John | Internal Medicine | 700 High Street, Williamsport, PA 17701-3198 | 2012-08-21 |
| 1639432628 | Ashley Nichole Pence | Pediatrics | 700 High Street, Williamsport, PA 17701-3198 | 2012-06-25 |
| 1912266685 | Brent M Carpenter | Nurse Anesthetist, Certified Registered | 700 High Street, Williamsport, PA 17701-3198 | 2012-05-15 |
| 1235366857 | Susquehanna Physician Services | Physician Assistant | 700 High Street, Williamsport, PA 17701-3198 | 2009-06-22 |
| 1518113570 | Marissa Lara Ambron | Internal Medicine | 700 High Street, Williamsport, PA 17701-3198 | 2008-08-11 |
| 1497962286 | Puneet Gupta | Internal Medicine | 700 High Street, Williamsport, PA 17701-3198 | 2007-05-17 |
| 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 | 207U00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Nuclear Medicine |
| A nuclear medicine specialist employs the properties of radioactive atoms and molecules in the diagnosis and treatment of disease and in research. Radiation detection and imaging instrument systems are used to detect disease as it changes the function and metabolism of normal cells, tissues and organs. A wide variety of diseases can be found in this way, usually before the structure of the organ involved by the disease can be seen to be abnormal by any other techniques. Early detection of coronary artery disease (including acute heart attack), early cancer detection and evaluation of the effect of tumor treatment, diagnosis of infection and inflammation anywhere in the body and early detection of blood clot in the lungs are all possible with these techniques. Unique forms of radioactive molecules can attack and kill cancer cells (e.g., lymphoma, thyroid cancer) or can relieve the severe pain of cancer that has spread to bone |
| 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 Nuclear Medicine, 2007. http://www.abnm.org/. A doctor of osteopathy was able to obtain a Certificate of Added Qualifications in the field of Nuclear Medicine. The Certificate is NO longer offered. - American Osteopathic Board of Nuclear Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Nuclear Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891841292 | John V Calce Md PC | Nuclear Medicine | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2007-01-26 |
| 1801978168 | John Vincent Calce | Nuclear Medicine | 700 High St, Williamsport, PA 17701-3198 | 2006-10-19 |
| 1356318356 | Judith Ann Gouldin | Nuclear Medicine | 777 Rural Ave, Williamsport, PA 17701-3109 | 2006-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801136627 | E Joan Graham | Nuclear Medicine | 384 W Broadway St, Plymouth, PA 18651-2508 | 2013-02-15 |
| 1992088975 | William A Wegener | Nuclear Medicine | 22 Stanfield Ave, Broomall, PA 19008-2743 | 2011-09-26 |
| 1790075638 | P. David Mozley | Nuclear Medicine | 1033 Anvil Dr, Collegeville, PA 19426-1570 | 2011-04-12 |
| 1114240546 | Cynthia Hinton Richards | Nuclear Medicine | 532 Maison Pl, Bryn Mawr, PA 19010-3610 | 2010-03-13 |
| 1548445026 | Suburban Imaging Associates, PC | Nuclear Medicine | 1615 Blackburn Heights Dr, Sewickley, PA 15143-8627 | 2008-01-03 |
| 1053420604 | Olympic Corporation, Inc. | Nuclear Medicine | 401 Smith Dr Ste 4, Cranberry Township, PA 16066-4132 | 2006-08-29 |
| 1639285521 | Peter G Gregory | Nuclear Medicine | 638 Fairview Rd, Clarks Summit, PA 18411-8955 | 2006-08-22 |
| 1740293232 | Univ of Penn Community Radiology | Nuclear Medicine | 999 Old Eagle School Rd, Wayne, PA 19087-1707 | 2006-08-14 |
| 1699782185 | Emilio G Flores Jr. | Nuclear Medicine | 100 Hospital Ave., Dubois, PA 15801-0447 | 2006-08-01 |
| 1326007766 | Pa Open Mri-harrisburg, PC | Nuclear Medicine | 5400d Chambers Hill Rd, Harrisburg, PA 17111-2505 | 2006-03-23 |
| 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.