| Susquehanna Health Medical Group | |
|
740 High St Suite 4001 Williamsport PA 17701-3100 | |
| (570) 321-2345 | |
| (570) 321-2359 |
| Full Name | Susquehanna Health Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 740 High St, Williamsport, Pennsylvania |
| Authorized Official Name and Position | Melissa Davis (VP/COO) |
| Authorized Official Contact | 5703207696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susquehanna Health Medical Group 1201 Grampian Blvd Williamsport PA 17701-1900 Ph: () - | Susquehanna Health Medical Group 740 High St Suite 4001 Williamsport PA 17701-3100 Ph: (570) 321-2345 |
| NPI Number | 1205870904 |
|---|---|
| Provider Enumeration Date | 06/15/2006 |
| Last Update Date | 10/20/2015 |
| Medicare PECOS PAC ID | 2264336460 |
|---|---|
| Medicare Enrollment ID | O20040225000410 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205870904 | NPI | - | NPPES |
| 0017300760210 | Medicaid | PA | |
| 880742 | Other | PA | HIGHMARK BLUE SHIELD |
| 0017300760162 | Medicaid | PA |
| Provider Name | David Bresticker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376582841 PECOS PAC ID: 6608886015 Enrollment ID: I20060501000251 |
| Provider Name | Timothy Michael Heilmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912968827 PECOS PAC ID: 7012052616 Enrollment ID: I20100308000327 |
| Provider Name | David Lopatofsky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487617155 PECOS PAC ID: 9537204987 Enrollment ID: I20100310000042 |
| Provider Name | William J Pagana |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972564565 PECOS PAC ID: 2668377284 Enrollment ID: I20100317001009 |
| Provider Name | Carrie A Timko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447228978 PECOS PAC ID: 1355476821 Enrollment ID: I20100323000424 |
| Provider Name | Jeffrey Nicholas Verzella |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043271968 PECOS PAC ID: 8123154721 Enrollment ID: I20100408000212 |
| Provider Name | Elizabeth Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427026970 PECOS PAC ID: 7618003146 Enrollment ID: I20100410000022 |
| Provider Name | Luan V Pham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558526665 PECOS PAC ID: 4981873486 Enrollment ID: I20110817000327 |
| Provider Name | John Boll |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073516944 PECOS PAC ID: 7719943489 Enrollment ID: I20120213000083 |
| Provider Name | Matthew Meeker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518288935 PECOS PAC ID: 8921246018 Enrollment ID: I20131004000007 |
| Provider Name | Leeanna Lyne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144517483 PECOS PAC ID: 4082852157 Enrollment ID: I20140904001555 |
| Provider Name | Sara E Swain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942597281 PECOS PAC ID: 3577709351 Enrollment ID: I20140904002194 |
| Provider Name | Elizabeth Klucka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366705808 PECOS PAC ID: 1951547280 Enrollment ID: I20150901001227 |
| Provider Name | Matthew James Groff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336578046 PECOS PAC ID: 0941586929 Enrollment ID: I20170405000775 |
| Provider Name | Glenn Michael Klucka |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1093058406 PECOS PAC ID: 4688978786 Enrollment ID: I20170911000129 |
| Provider Name | Dana Marie Kirschner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891175147 PECOS PAC ID: 4981917176 Enrollment ID: I20180912000116 |
| Provider Name | Morgan Rogers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326498726 PECOS PAC ID: 8325330087 Enrollment ID: I20191002002892 |
| Provider Name | Brian Kaderli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477992519 PECOS PAC ID: 5496044752 Enrollment ID: I20200504000008 |
| Provider Name | Courtney Leigh Goettel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114410529 PECOS PAC ID: 8022366053 Enrollment ID: I20210903000570 |
| Provider Name | Adwoa Kyeiwa Boahene |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558858340 PECOS PAC ID: 0345648028 Enrollment ID: I20211011001396 |
| Provider Name | Enoch S Tse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871056556 PECOS PAC ID: 4082948914 Enrollment ID: I20220720000706 |
| Provider Name | Rebecca A Rickard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790340677 PECOS PAC ID: 4385979749 Enrollment ID: I20221011001382 |
| Provider Name | Jeniece Alison Cooper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861015596 PECOS PAC ID: 4880055490 Enrollment ID: I20230731000145 |
| Provider Name | Joshua L Dearing |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851912182 PECOS PAC ID: 1951722891 Enrollment ID: I20230829001281 |
Gillum Psychological & Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 454 Pine St, Suite 1b, Williamsport, PA 17701 Phone: 570-321-6390 Fax: 570-321-6393 | |
Crossroads Counseling, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 East Third Street, Williamsport, PA 17701 Phone: 570-323-7535 Fax: 570-323-3790 | |
Lawrence M Satifka Ma Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Pine St Ste 400, Williamsport, PA 17701 Phone: 570-772-3090 Fax: 570-300-2371 | |
L.c.c.c.s Children's Development Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 625 W Edwin St, Williamsport, PA 17701 Phone: 570-326-0565 Fax: 570-329-2522 | |
Diakon Family Life Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 435 W 4th St, Williamsport, PA 17701 Phone: 570-322-7873 Fax: 570-322-8026 | |
Williamsport Psychological Associates Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 811 Market St, Williamsport, PA 17701 Phone: 570-322-2603 Fax: 570-322-4208 | |
Diakon Child,family&community Ministries Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1801 Loyalsock Dr, Williamsport, PA 17701 Phone: 570-322-7873 Fax: 570-322-8026 |