| Susquehanna Health Medical Group | |
|
1100 Grampian Blvd Williamsport PA 17701-1909 | |
| (570) 320-7691 | |
| (570) 320-7898 |
| Full Name | Susquehanna Health Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 1100 Grampian Blvd, 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 1100 Grampian Blvd Williamsport PA 17701-1909 Ph: (570) 320-7691 |
| NPI Number | 1083655542 |
|---|---|
| Provider Enumeration Date | 06/08/2006 |
| Last Update Date | 10/22/2015 |
| Medicare PECOS PAC ID | 2264336460 |
|---|---|
| Medicare Enrollment ID | O20060814000331 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083655542 | NPI | - | NPPES |
| 1860453 | Other | PA | HIGHMARK BLUE SHIELD |
| 0017300760179 | Medicaid | PA |
| Provider Name | Luke Adam Stefanile |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558338897 PECOS PAC ID: 3678567765 Enrollment ID: I20040412001405 |
| Provider Name | Wendy S Fetzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437250578 PECOS PAC ID: 1658367099 Enrollment ID: I20040422000041 |
| Provider Name | Karl M Ahlswede |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1033198676 PECOS PAC ID: 6608846779 Enrollment ID: I20040727000956 |
| Provider Name | Alexander R Nesbitt |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1285695411 PECOS PAC ID: 1658276274 Enrollment ID: I20050105000285 |
| Provider Name | Rosemary A Wiegand |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245239870 PECOS PAC ID: 5496804577 Enrollment ID: I20090520000171 |
| Provider Name | Donna Eileen Mullarkey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376588426 PECOS PAC ID: 9133181472 Enrollment ID: I20090921000413 |
| Provider Name | Bharat G Adroja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821070947 PECOS PAC ID: 4981591872 Enrollment ID: I20101109001039 |
| Provider Name | Kimberly Ann Pish |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821225681 PECOS PAC ID: 6406003987 Enrollment ID: I20120906000379 |
| Provider Name | Jennifer E Bayer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902804339 PECOS PAC ID: 5092793000 Enrollment ID: I20121106000444 |
| Provider Name | Boris Goralnik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366776742 PECOS PAC ID: 6800070590 Enrollment ID: I20130819000637 |
| Provider Name | Amy B Adrian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508298316 PECOS PAC ID: 8426285727 Enrollment ID: I20131212000160 |
| Provider Name | Jenna Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649567975 PECOS PAC ID: 6204072390 Enrollment ID: I20140902001861 |
| Provider Name | Rosanne Mattiace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407262652 PECOS PAC ID: 2466673934 Enrollment ID: I20141027000606 |
| Provider Name | Krista Straniere |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497144125 PECOS PAC ID: 4082925391 Enrollment ID: I20150612000552 |
| Provider Name | Laura E Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326593963 PECOS PAC ID: 1759679053 Enrollment ID: I20161019000194 |
| Provider Name | Margaret S Frock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326593278 PECOS PAC ID: 1759661572 Enrollment ID: I20161213000346 |
| Provider Name | Danielle Renae Brannon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184073025 PECOS PAC ID: 3173810108 Enrollment ID: I20170615000209 |
| Provider Name | Sandra Marie Ahlswede |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871001669 PECOS PAC ID: 6103188131 Enrollment ID: I20180402001757 |
| Provider Name | Lara Jaussi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124408471 PECOS PAC ID: 1850604042 Enrollment ID: I20180726000640 |
| Provider Name | Felicia Ann Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184108540 PECOS PAC ID: 7719230655 Enrollment ID: I20181023003201 |
| Provider Name | Jodi Huling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902475064 PECOS PAC ID: 3870996374 Enrollment ID: I20210721002215 |
| Provider Name | Viorica Valentin Velott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699300954 PECOS PAC ID: 5799188140 Enrollment ID: I20210723000186 |
| Provider Name | Fnu Rahool |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851888531 PECOS PAC ID: 9436402112 Enrollment ID: I20220718000314 |
| Provider Name | Megan Elizabeth Saunders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639952864 PECOS PAC ID: 7113372038 Enrollment ID: I20231012003631 |
| Provider Name | Emily C Glackin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619742087 PECOS PAC ID: 8527417989 Enrollment ID: I20231211000849 |
Susquehanna Health Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1705 Warren Ave, Suite 303, Williamsport, PA 17701 Phone: 570-326-8500 Fax: 570-326-8049 | |
Divine Providence Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 471 Hepburn St, Williamsport, PA 17701 Phone: 570-567-5400 Fax: 570-326-8601 | |
White Deer Run Of Williamsport Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 520 W 4th St, Williamsport, PA 17701 Phone: 570-322-4836 Fax: 570-322-4769 | |
Geisinger-hm Joint Venture, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1824 E 3rd St, Williamsport, PA 17701 Phone: 570-601-2200 Fax: 570-601-2202 | |
Open Arms Internal Medicine & Pediatrics, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3155 Lycoming Creek Rd, Williamsport, PA 17701 Phone: 570-244-1877 | |
Sps-peck Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 904 Campbell St, Suite 202, Williamsport, PA 17701 Phone: 570-321-2290 Fax: 570-321-2289 |