SUSQUEHANNA HEALTH MEDICAL GROUP
NPI 1770719882
Obstetrics & Gynecology in Williamsport, PA
NPI Status: Active since June 03, 2009
Contact Information
740 HIGH STREET
SUITE 1004
WILLIAMSPORT, PA
ZIP 17701
Phone: (570) 321-3300
Fax: (570) 321-3301
- Organization
- Obstetrics & Gynecology
- CLIA Number: 39D2278738
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 03-22-2027
About SUSQUEHANNA HEALTH MEDICAL GROUP
This page provides the complete NPI Profile along with additional information for Susquehanna Health Medical Group, a women's health care provider established in Williamsport, Pennsylvania operating as a Obstetrics & Gynecology. The healthcare provider is registered in the NPI registry with number 1770719882 assigned on June 2009. The practitioner's primary taxonomy code is 207V00000X. The provider is registered as an organization and their NPI record was last updated 10 years ago. Susquehanna Health Medical Group operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Susquehanna Health Medical Group. The authorized official of this NPI record is Ms. Melissa Davis (Vp/coo)
- NPI
- 1770719882
- Provider Legal Name
- SUSQUEHANNA PHYSICIAN SERVICES
- Other Organization Name
- SUSQUEHANNA HEALTH MEDICAL GROUP
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 740 HIGH STREET SUITE 1004 WILLIAMSPORT, PA 17701
- Location Phone
- (570) 321-3300
- Location Fax
- (570) 321-3301
- Mailing Address
- 1201 GRAMPIAN BLVD WILLIAMSPORT, PA 17701
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-03-2009
- Last Update Date
- 10-22-2015
- Code Navigator
Women's health care providers like Susquehanna Health Medical Group treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Obstetrics & Gynecology
- Taxonomy Code
- 207V00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 363LW0102X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | |
| 2 | 367A00000X | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 0017300760173 | MEDICAID (05) | PA | |
| 2104850 | OTHER (01) | PA | HIGHMARK BLUE SHIELD |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 39D2278738
- Facility Type
- Physician Office
- Certificate Effective Date
- March 23, 2025
- Certificate Expiration Date
- March 22, 2027
- Laboratory Director
- DR. JOSHUA J. STUTZMAN
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Susquehanna Health Medical Group in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 7 | 0 | 7 | 1 | 9 | 8 | 8 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 14 | 0 | 14 | 1 | 18 | 8 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 4 + 0 + 1 + 4 + 1 + 1 + 8 + 8 + 1 + 6 + 24 = 68 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 68 = 2 | 2 | ||||||||
The NPI number 1770719882 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 5 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1487827002 | SUSAN E KING LCSW Individual | Social Worker (Clinical) | 740 HIGH STREET SUITE 4001 WILLIAMSPORT, PA 17701 (570) 321-2345 |
| 1568157584 | CHELSEA LYNN TONER D.O. Individual | Student in an Organized Health Care Education/Training Program | 740 HIGH STREET SUITE 4001 WILLIAMSPORT, PA 17701 (570) 321-2345 |
| 1881951762 | DR. NATASHA RACHELL ALLIGOOD-PERCOCO M.D. Individual | Obstetrics & Gynecology | 740 HIGH STREET SUITE 1004 WILLIAMSPORT, PA 17701 (570) 321-3300 |
| 1740970037 | HAILEY LEIGHANN CHAPIN DO Individual | Student in an Organized Health Care Education/Training Program | 740 HIGH STREET SUITE 4001 WILLIAMSPORT, PA 17701 (570) 321-2345 |
| 1891541934 | DR. KAYLA ALEXIS LEE MD Individual | Student in an Organized Health Care Education/Training Program | 740 HIGH STREET SUITE 4001 WILLIAMSPORT, PA 17701 (571) 321-2345 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1770719882, enumerated in the NPI registry as an "organization" on June 03, 2009
The provider is located at 740 High Street Suite 1004 Williamsport, Pa 17701 and the phone number is (570) 321-3300
This medical organization specializes in Obstetrics & Gynecology with taxonomy code 207V00000X
The provider might be accepting Accepts: Medicare, Medicaid, Blue Cross Blue Shield and. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 39D2278738 for a "physician office" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing..
This NPI record was last updated on June 03, 2009. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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