| Susquehanna Health Medical Group | |
|
1100 Grampian Blvd Williamsport PA 17701-1909 | |
| (570) 320-7848 | |
| (570) 320-7856 |
| Full Name | Susquehanna Health Medical Group |
|---|---|
| Speciality | Internal 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) 320-7848 |
| NPI Number | 1184652133 |
|---|---|
| Provider Enumeration Date | 06/29/2006 |
| Last Update Date | 10/20/2015 |
| Medicare PECOS PAC ID | 2264336460 |
|---|---|
| Medicare Enrollment ID | O20040216000018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184652133 | NPI | - | NPPES |
| 0017300760191 | Medicaid | PA | |
| 880543 | Other | PA | HIGHMARK BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Maja Stefanovic Racic |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1245205285 PECOS PAC ID: 7012814296 Enrollment ID: I20031216000466 |
| Provider Name | Frederico G Toledo |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1598731895 PECOS PAC ID: 4688658917 Enrollment ID: I20040615000991 |
| Provider Name | Erin Kershaw |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1346228228 PECOS PAC ID: 7214908276 Enrollment ID: I20090615000451 |
| Provider Name | Jason M Ng |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1619135795 PECOS PAC ID: 8426197138 Enrollment ID: I20091209000070 |
| Provider Name | Helena E Levitt |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1699988493 PECOS PAC ID: 8325227044 Enrollment ID: I20110127000530 |
| Provider Name | David A Rometo |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1992921464 PECOS PAC ID: 1052599206 Enrollment ID: I20110617000315 |
| Provider Name | Esra Karslioglu French |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1093907305 PECOS PAC ID: 8820265341 Enrollment ID: I20120124000201 |
| Provider Name | Hussain Mahmud |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1336333210 PECOS PAC ID: 5890951511 Enrollment ID: I20120725000425 |
| Provider Name | Lauren A Willard |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1760610059 PECOS PAC ID: 7416171244 Enrollment ID: I20140617000791 |
| Provider Name | Wynn Htun |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1053742452 PECOS PAC ID: 6406147420 Enrollment ID: I20160622002338 |
| Provider Name | Elena M Morariu |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1972892990 PECOS PAC ID: 1951696798 Enrollment ID: I20160818001189 |
| Provider Name | Yunjiao J Wang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891084299 PECOS PAC ID: 2365677044 Enrollment ID: I20160825000664 |
| Provider Name | Sylvester Odeke |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1265426787 PECOS PAC ID: 9436281839 Enrollment ID: I20171117001672 |
| Provider Name | Jagdeesh Ullal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932362399 PECOS PAC ID: 3476686510 Enrollment ID: I20171227000367 |
| Provider Name | Vijay K Yechoor |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1568656551 PECOS PAC ID: 9133299688 Enrollment ID: I20180604002465 |
| Provider Name | Sheba Syeda Asghar |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1780865758 PECOS PAC ID: 2567543150 Enrollment ID: I20180724003069 |
| Provider Name | Ann-marie Busick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518309814 PECOS PAC ID: 5597058297 Enrollment ID: I20181119000105 |
| Provider Name | Karen E Friday |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1295994432 PECOS PAC ID: 0648287003 Enrollment ID: I20190123002594 |
| Provider Name | Scott A Segel |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1063416535 PECOS PAC ID: 7012803448 Enrollment ID: I20190521002903 |
| Provider Name | Robert J Cooper |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1992739726 PECOS PAC ID: 2961393723 Enrollment ID: I20190604003288 |
| Provider Name | Theresa Rose Hershberger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760941355 PECOS PAC ID: 8527391580 Enrollment ID: I20190605002457 |
| Provider Name | Diana Pinkhasova |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1346668084 PECOS PAC ID: 3072819903 Enrollment ID: I20190625002450 |
| Provider Name | Charity Mooya Kwamanakweenda |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1144649302 PECOS PAC ID: 9638473960 Enrollment ID: I20190729001067 |
| Provider Name | Amanda Nichole Smithgall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689905622 PECOS PAC ID: 2264565753 Enrollment ID: I20191106001281 |
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 | |
Susquehanna Health Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1100 Grampian Blvd, Williamsport, PA 17701 Phone: 570-320-7691 Fax: 570-320-7898 | |
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 |