WELLSPAN FAMILY MEDICINE - FREDERICK ST
NPI 1114292760
Family Medicine in Hanover, PA

Active since March 15, 2012CLIA 39D1048135 · Waiver
100 FREDERICK ST, SUITE 101, HANOVER, PA 17331(717) 851-7050(717) 632-7478 Get Directions Write a Review

NPPES record last updated: January 11, 2018. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 11, 2018, Dec 22, 2015 (2 updates tracked since 2015).

About Wellspan Family Medicine - Frederick St NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WELLSPAN FAMILY MEDICINE - FREDERICK ST (NPI 1114292760) is a healthcare organization registered as a family medicine in Hanover, Pennsylvania and active in the NPI registry since March 2012. The organization holds a CLIA Waiver certificate valid through June 20, 2028 and lists Christina Vest, Credentialing Supervisor, as its authorized official.

NPPES Registry Identity

NPI1114292760
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameWELLSPAN MEDICAL GROUP
Location Address100 FREDERICK ST, SUITE 101Hanover, PA 17331-3518
Mailing Address1803 Mount Rose Ave, Suite B3York, PA 17403-3026 · (717) 851-6816 · Fax (717) 632-7478
Fax(717) 632-7478
Organization SubpartNo
Authorized OfficialChristina VestCredentialing Supervisor · (717) 851-1405
Enumeration DateMarch 15, 2012
Last NPPES UpdateJanuary 11, 20182 updates tracked since enumeration
✔ NPI 1114292760 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
100 FREDERICK ST, Hanover, PA 17331

Other Names 1

Doing Business AsWellspan Family Medicine - Frederick St

Other Identifiers 5

Other2695421PA · Highmark Blue Shield
Other30112625PA · Amerihealth Mercy - Wmg
Other1603334PA · Gateway Health Plan
Other50107968PA · Capital Blue Cross - Wmg
Other9886818PA · Aetna

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wellspan Family Medicine - Frederick St is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3,072

Medicare enrollment records show 3,072 clinicians reassign Medicare billing to Wellspan Family Medicine - Frederick St, which bills Medicare for the services they deliver. Of these, 7 practice at this address and 66 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 65

Nurse Practitioner658
Certified Registered Nurse Anesthetist (CRNA)284
Family Practice275
Hospitalist205
Internal Medicine138
Obstetrics/Gynecology123
Anesthesiology107
Neurology100
57 other specialties1,182

Nearest to this location (20)

See all 3,072
Nurse Practitioner
NPI 1407467848
100 FREDERICK ST STE 101
Hanover, PA 17331
(717) 851-7050
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1538567565
100 FREDERICK ST STE 101
Hanover, PA 17331
(717) 851-7050
✔ PECOSSame address
Nurse Practitioner
NPI 1952037558
100 FREDERICK ST STE 101
Hanover, PA 17331
(717) 851-7050
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1801290325
100 FREDERICK ST STE 101
Hanover, PA 17331
(717) 851-7050
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1508418120
100 FREDERICK ST STE 101
Hanover, PA 17331
(717) 851-7050
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1639894561
100 FREDERICK ST STE 101
Hanover, PA 17331
(717) 851-7050
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1619658770
100 FREDERICK ST STE 101
Hanover, PA 17331
(717) 851-7050
✔ PECOS✔ Accepts MedicareSame address
Certified Nurse Midwife (CNM)
NPI 1629423439
20 NORTH ST
Hanover, PA 17331
(717) 637-7755
✔ PECOS0.4 mi
Certified Nurse Midwife (CNM)
NPI 1801249743
20 NORTH ST
Hanover, PA 17331
(717) 637-7755
✔ PECOS✔ Accepts Medicare0.4 mi
Certified Nurse Midwife (CNM)
NPI 1275065443
20 NORTH ST
Hanover, PA 17331
(717) 637-7755
✔ PECOS0.4 mi
Obstetrics/Gynecology
NPI 1023371754
20 NORTH ST
Hanover, PA 17331
(717) 637-7755
✔ PECOS✔ Accepts Medicare0.4 mi
Family Practice
NPI 1669821476
425 WESTMINSTER AVE SUITE A3
Hanover, PA 17331
(717) 316-3481
✔ PECOS✔ Accepts Medicare1.1 mi
Podiatry
NPI 1205815479
1010 EICHELBERGER ST SUITE 4
Hanover, PA 17331
(717) 757-3537
✔ PECOS✔ Accepts Medicare1.3 mi
Mental Health Counselor
NPI 1669702668
949 BROADWAY
Hanover, PA 17331
(717) 630-8570
✔ PECOS1.5 mi
Nurse Practitioner
NPI 1750786398
1150 CARLISLE ST
Hanover, PA 17331
(717) 851-7070
✔ PECOS1.7 mi
Orthopedic Surgery
NPI 1316926769
207 BLOOMING GROVE RD
Hanover, PA 17331
(717) 812-7559
✔ PECOS✔ Accepts Medicare1.8 mi
Gastroenterology
NPI 1467451468
1227 BALTIMORE ST
Hanover, PA 17331
(717) 812-5130
✔ PECOS✔ Accepts Medicare2.0 mi
Pain Management
NPI 1891189718
1227 BALTIMORE ST
Hanover, PA 17331
(717) 812-2055
✔ PECOS✔ Accepts Medicare2.0 mi
Nephrology
NPI 1992830509
1227 BALTIMORE ST
Hanover, PA 17331
(717) 339-2760
✔ PECOS✔ Accepts Medicare2.0 mi
Sports Medicine
NPI 1396366332
1227 BALTIMORE ST
Hanover, PA 17331
(717) 812-7559
✔ PECOS✔ Accepts Medicare2.0 mi
See all 3,072 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 39D1048135

Wellspan Family Medicine Frederick St · Hanover, PA
Active · expires Jun 20, 2028
CLIA Number39D1048135
Laboratory TypePhysician Office
Certificate Effective DateJune 21, 2026
Certificate Expiration DateJune 20, 2028
Laboratory DirectorDr. G Panisri Rao
Laboratory Phone(717) 632-7474
Laboratory LocationWellspan Family Medicine Frederick St100 Frederick Street, Suite 101, Hanover, PA 17331
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wellspan Medical Group's NPI number?

The NPI number for Wellspan Medical Group is 1114292760. It was assigned to this organization in the NPPES registry on March 15, 2012. The provider is doing business as Wellspan Family Medicine - Frederick St.

Where is Wellspan Medical Group located?

Wellspan Medical Group is located at 100 Frederick St Suite 101, Hanover, PA 17331. The listed phone number is (717) 851-7050.

What is Wellspan Medical Group's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Wellspan Medical Group enrolled in Medicare?

Yes. Wellspan Medical Group is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Wellspan Medical Group?

According to the CMS Revalidation Reassignment List (October 2026 release), 3,072 clinicians in 65 Medicare specialties reassign their Medicare billing to Wellspan Medical Group. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (658), Certified Registered Nurse Anesthetist (CRNA) (284) and Family Practice (275). Of these, 7 practice at this address and 66 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Wellspan Medical Group hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D1048135) is associated with this NPI, valid through June 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wellspan Medical Group was last updated on January 11, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.