| Geisinger Jersey Shore Hospital | |
|
1020 Thompson St Jersey Shore PA 17740-1729 | |
| (570) 398-0100 | |
| (570) 398-4412 |
| Full Name | Geisinger Jersey Shore Hospital |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 1020 Thompson St, Jersey Shore, Pennsylvania |
| Authorized Official Name and Position | Cindy L Mull (SYSTEM DIRECTOR CREDENENROLLMENTS) |
| Authorized Official Contact | 5702716603 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Geisinger Jersey Shore Hospital 100 N Academy Ave Danville PA 17822-4903 Ph: (570) 271-6144 | Geisinger Jersey Shore Hospital 1020 Thompson St Jersey Shore PA 17740-1729 Ph: (570) 398-0100 |
| NPI Number | 1366407587 |
|---|---|
| Provider Enumeration Date | 04/19/2006 |
| Last Update Date | 12/10/2024 |
| Medicare PECOS PAC ID | 7517954209 |
|---|---|
| Medicare Enrollment ID | O20061104000518 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366407587 | NPI | - | NPPES |
| 009912 | Other | FIRST PRIORITY HEALTH | |
| 10011 | Other | GEISINGER HEALTH PLAN | |
| 5511 | Other | HEALTH AMERICA | |
| 391300 | Other | BLUE CROSS | |
| 1007703560003 | Medicaid | PA | |
| 59746 | Other | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 282NC0060X | General Acute Care Hospital - Critical Access | 101401 (Pennsylvania) | Primary |
| Provider Name | Catherine Ann Brosius-bolick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336218528 PECOS PAC ID: 2062300247 Enrollment ID: I20040309000673 |
| Provider Name | Tammy L Harding-anderer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265406409 PECOS PAC ID: 8527050541 Enrollment ID: I20040331000852 |
| Provider Name | William J Schlorff |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1114987930 PECOS PAC ID: 4082690375 Enrollment ID: I20040628000398 |
| Provider Name | Sean T Devine |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1861468944 PECOS PAC ID: 8123069259 Enrollment ID: I20050518000932 |
| Provider Name | Anwer Qureshi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588629521 PECOS PAC ID: 9537104351 Enrollment ID: I20050622001037 |
| Provider Name | Jaime Charles Lent |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205882776 PECOS PAC ID: 8022115575 Enrollment ID: I20070518000114 |
| Provider Name | Lynn A Grove |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1043426828 PECOS PAC ID: 7012003213 Enrollment ID: I20071019000049 |
| Provider Name | Brian P Oppermann |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1194904797 PECOS PAC ID: 1052409661 Enrollment ID: I20071115000379 |
| Provider Name | Mark E Armstrong |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013981711 PECOS PAC ID: 6103916523 Enrollment ID: I20071221000102 |
| Provider Name | Paul F Simonelli |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1013918424 PECOS PAC ID: 5395820468 Enrollment ID: I20080313000264 |
| Provider Name | Joyce A Burnside |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1568437457 PECOS PAC ID: 2961587076 Enrollment ID: I20080313000593 |
| Provider Name | Qingzhong Hao |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1063481836 PECOS PAC ID: 6406933290 Enrollment ID: I20080403000157 |
| Provider Name | Robert Oelhaf |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285687525 PECOS PAC ID: 3678624764 Enrollment ID: I20090701000172 |
| Provider Name | Randal L Shelly |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730180126 PECOS PAC ID: 7012102163 Enrollment ID: I20101115000516 |
| Provider Name | William Haynos |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093786923 PECOS PAC ID: 0941288468 Enrollment ID: I20110509000549 |
| Provider Name | Robert E Purcell |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1992700900 PECOS PAC ID: 2062589054 Enrollment ID: I20110613000240 |
| Provider Name | Lisa M Hoffman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386888287 PECOS PAC ID: 3971765066 Enrollment ID: I20120508000105 |
| Provider Name | Jason M Schauer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376785535 PECOS PAC ID: 9436315553 Enrollment ID: I20120718000198 |
| Provider Name | Scott Vaughan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1386806628 PECOS PAC ID: 1658537915 Enrollment ID: I20130807000165 |
| Provider Name | Wingrove T Jarvis |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1780725051 PECOS PAC ID: 6800935164 Enrollment ID: I20130827000617 |
| Provider Name | Lauren Ann Love |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326488677 PECOS PAC ID: 5395988695 Enrollment ID: I20130906000136 |
| Provider Name | Farrukh A Khan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1871594077 PECOS PAC ID: 5395710685 Enrollment ID: I20131203001680 |
| Provider Name | Vishal Mehra |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306934740 PECOS PAC ID: 5496704959 Enrollment ID: I20140702000510 |
| Provider Name | Nicholas C Purdy |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1710112024 PECOS PAC ID: 7012156912 Enrollment ID: I20141110000724 |
| Provider Name | Nicolas N Mead |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548433758 PECOS PAC ID: 6901117993 Enrollment ID: I20150617001358 |
| Provider Name | Mary A Herman |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1265535553 PECOS PAC ID: 4880694595 Enrollment ID: I20150921000981 |
| Provider Name | Claire Therese R Southern |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386991487 PECOS PAC ID: 9234447855 Enrollment ID: I20151001001049 |
| Provider Name | Christopher J Whiting |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104168533 PECOS PAC ID: 5496058653 Enrollment ID: I20170712000848 |
| Provider Name | Tamoor Shahid |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1760890909 PECOS PAC ID: 4082986617 Enrollment ID: I20170817000195 |
| Provider Name | Mariola Pistoia |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740531524 PECOS PAC ID: 4082863071 Enrollment ID: I20170821000529 |
| Provider Name | Marika Bergenstock |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518386960 PECOS PAC ID: 5890061642 Enrollment ID: I20171023000286 |
| Provider Name | Jed T Ritter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790170934 PECOS PAC ID: 4789980590 Enrollment ID: I20180530001800 |
| Provider Name | Brendan James Carry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376836395 PECOS PAC ID: 8022300433 Enrollment ID: I20180531000068 |
| Provider Name | David Decoskey |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396136065 PECOS PAC ID: 0042514895 Enrollment ID: I20180531000563 |
| Provider Name | David C Mack |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588059984 PECOS PAC ID: 9931403128 Enrollment ID: I20180621000970 |
| Provider Name | Rizwan Tahir |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1538395272 PECOS PAC ID: 8527232818 Enrollment ID: I20180913000174 |
| Provider Name | Daniel Valdes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528427101 PECOS PAC ID: 9830432392 Enrollment ID: I20190524000191 |
| Provider Name | Kyle Yebernetsky |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235592593 PECOS PAC ID: 7810284635 Enrollment ID: I20190524001128 |
| Provider Name | Rebecca Lynn Hoffman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1740508233 PECOS PAC ID: 3274832688 Enrollment ID: I20190826003859 |
| Provider Name | David Rupprecht |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679008247 PECOS PAC ID: 8628321494 Enrollment ID: I20200629002814 |
| Provider Name | Joan Oguntimein |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1861846008 PECOS PAC ID: 7618260050 Enrollment ID: I20200805001495 |
| Provider Name | Matthew Payne |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1023628484 PECOS PAC ID: 9638596240 Enrollment ID: I20200827002527 |
| Provider Name | Corey Dietz |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740737865 PECOS PAC ID: 5799065157 Enrollment ID: I20200922000004 |
| Provider Name | Kristopher Pfirman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306233804 PECOS PAC ID: 6709174360 Enrollment ID: I20210624002395 |
| Provider Name | Jason Stankiewicz |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1720421431 PECOS PAC ID: 2668787276 Enrollment ID: I20210713002294 |
| Provider Name | Angel Rafael Diaz Sanchez |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1346771565 PECOS PAC ID: 5496157471 Enrollment ID: I20210713003430 |
| Provider Name | Yingyi Wu |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912428947 PECOS PAC ID: 1658777990 Enrollment ID: I20210910002735 |
| Provider Name | Garrett Todd Stoltzfus |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770043127 PECOS PAC ID: 4587990957 Enrollment ID: I20220816001228 |
| Provider Name | Ishmail Saccoh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1437651338 PECOS PAC ID: 1355698358 Enrollment ID: I20220824001977 |
| Provider Name | Muhammad Anwar |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1265538052 PECOS PAC ID: 4688759012 Enrollment ID: I20220829001321 |
| Provider Name | Carol Stojinski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740843424 PECOS PAC ID: 4981074028 Enrollment ID: I20230105001461 |
| Provider Name | Samuel Robert Batchelor |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1942992540 PECOS PAC ID: 1951762418 Enrollment ID: I20230731002459 |
| Provider Name | Robert Joseph Anderson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235758947 PECOS PAC ID: 3971926296 Enrollment ID: I20230804002094 |
| Provider Name | Oliver Ruiz |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1073132924 PECOS PAC ID: 5193148484 Enrollment ID: I20230822000234 |
| Provider Name | James Paul Piper |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1962935957 PECOS PAC ID: 2466721477 Enrollment ID: I20230829002895 |
| Provider Name | Brendan Steele |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265061865 PECOS PAC ID: 4981027273 Enrollment ID: I20231012000849 |
| Provider Name | Ekaterina Halivelakis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1104455104 PECOS PAC ID: 2365864816 Enrollment ID: I20240828001311 |
| Provider Name | Matthew Alexander Rae |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1033614649 PECOS PAC ID: 7911255484 Enrollment ID: I20240914000258 |
| Provider Name | Hau Ngoc Thi Phan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1801458146 PECOS PAC ID: 9537690821 Enrollment ID: I20240926003018 |
Geisinger Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1020 Thompson St, Jersey Shore, PA 17740 Phone: 570-398-1991 Fax: 570-398-4607 | |
River Valley Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 259 Allegheny St, Jersey Shore, PA 17740 Phone: 570-567-5418 Fax: 570-666-3074 | |
Cynthia K. Recinto, Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 990 Thompson St, Jersey Shore, PA 17740 Phone: 570-398-2600 Fax: 570-398-2055 |