- Medicare Primary Care in South Williamsport, PA

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is a medicare enrolled primary clinic (Family Medicine) in South Williamsport, Pennsylvania. The current practice location for is 145 Shaffer St, South Williamsport, Pennsylvania. For appointments, you can reach them via phone at (570) 326-2447. The mailing address for is 1201 Grampian Blvd, Williamsport, Pennsylvania and phone number is () -.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1780631226. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (570) 326-2447.

Contact Information

145 Shaffer St
South Williamsport
PA 17702-6727
(570) 326-2447
(570) 326-1247

Map and Direction


Primary Care Clinic Profile

Full Name
SpecialityFamily Medicine
Location145 Shaffer St, South Williamsport, Pennsylvania
Authorized Official Name and PositionMelissa Davis (VP/COO)
Authorized Official Contact5703207696
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address

1201 Grampian Blvd
Williamsport
PA 17701-1900

Ph: () -
145 Shaffer St
South Williamsport
PA 17702-6727

Ph: (570) 326-2447

NPI Details:

NPI Number1780631226
Provider Enumeration Date05/30/2006
Last Update Date10/26/2015

Medicare PECOS Information:

Medicare PECOS PAC ID2264336460
Medicare Enrollment IDO20040709000444

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1780631226NPI-NPPES
888650OtherPAHIGHMARK BLUE SHIELD
0017300760153MedicaidPA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Primary
363L00000XNurse Practitioner (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:
Provider NameDavid Lopatofsky
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1487617155
PECOS PAC ID: 9537204987
Enrollment ID: I20100310000042
Provider NameMichelle L Cavanaugh
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1023082351
PECOS PAC ID: 6103011176
Enrollment ID: I20101116000831
Provider NameSara E Swain
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1942597281
PECOS PAC ID: 3577709351
Enrollment ID: I20140904002194
Provider NameElizabeth Klucka
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1366705808
PECOS PAC ID: 1951547280
Enrollment ID: I20150901001227
Provider NameShelly Marie Conner
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1114301165
PECOS PAC ID: 3678863255
Enrollment ID: I20160610000073
Provider NameSantisree Tanikella
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1710265467
PECOS PAC ID: 9436428034
Enrollment ID: I20170712002685
Provider NameDanielle M Mcgovern
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1740713635
PECOS PAC ID: 5597039321
Enrollment ID: I20200709001899
Provider NameBrittney Michael Welshans
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1679226120
PECOS PAC ID: 1052707684
Enrollment ID: I20220408000037
Provider NameSunkesula K Sagar
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1588125975
PECOS PAC ID: 4880929371
Enrollment ID: I20220831003315
Provider NameDeanna Kay Bump
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1972225563
PECOS PAC ID: 9133598782
Enrollment ID: I20221203000574
Provider NameMichael Su
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1639707326
PECOS PAC ID: 6103270517
Enrollment ID: I20231003002526
Provider NameDaniel F Schuler
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1861013682
PECOS PAC ID: 3274957238
Enrollment ID: I20231016003429
Provider NameJonathan William Seiferth
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1386224384
PECOS PAC ID: 7517369192
Enrollment ID: I20240910004944

Reviews and Comments


Family Medicine in South Williamsport, PA


Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 699 Hastings St, South Williamsport, PA 17702
Phone: 570-327-1335    Fax: 570-321-7800

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.