WELLSPAN FAMILY MEDICINE - NORTH FOURTH STREET
NPI 1316076961
Family Medicine in Lebanon, PA
About Wellspan Family Medicine - North Fourth Street NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WELLSPAN FAMILY MEDICINE - NORTH FOURTH STREET (NPI 1316076961) is a healthcare organization registered as a family medicine in Lebanon, Pennsylvania and active in the NPI registry since March 2007. The organization lists Jody M Boger, Credentialing Coordinator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Other Identifiers 2
Group Practice 1
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 - North Fourth Street is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
141Medicare enrollment records show 141 clinicians reassign Medicare billing to Wellspan Family Medicine - North Fourth Street, which bills Medicare for the services they deliver. Of these, 16 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 13
Nearest to this location (20)
See all 141Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Good Samaritan Physician Services's NPI number?
The NPI number for Good Samaritan Physician Services is 1316076961. It was assigned to this organization in the NPPES registry on March 2, 2007. The provider is doing business as Wellspan Family Medicine - North Fourth Street.
Where is Good Samaritan Physician Services located?
Good Samaritan Physician Services is located at 30 N 4th St 2nd Floor, Lebanon, PA 17046. The listed phone number is (717) 274-0474.
What is Good Samaritan Physician Services's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Good Samaritan Physician Services enrolled in Medicare?
Yes. Good Samaritan Physician Services is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Good Samaritan Physician Services?
According to the CMS Revalidation Reassignment List (October 2026 release), 141 clinicians in 13 Medicare specialties reassign their Medicare billing to Good Samaritan Physician Services. 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 (69), Family Practice (21) and Hematology/Oncology (11). Of these, 16 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Good Samaritan Physician Services was last updated on October 4, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Wellspan Family Medicine - North Fourth Street · NPI 1316076961
Family Medicine organization in Lebanon, Pennsylvania. Organization record, active in the CMS NPPES registry since March 2, 2007.
## Identity
- **NPI:** 1316076961 (Entity type: Organization)
- **Enumerated:** March 2, 2007
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Good Samaritan Physician Services
- **Organization subpart:** No
- **Authorized official:** Jody Boger, CREDENTIALING COORDINATOR
## Practice location
- **Address:** 30 N 4TH ST, 2ND FLOOR, Lebanon, PA 17046-5606
- **Phone:** (717) 274-0474 · **Fax:** (717) 274-0673
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 141 clinicians in 13 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (69), Family Practice (21), Hematology/Oncology (11); 16 practice within 10 miles; [full list](https://npiprofile.com/npi/1316076961/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 4, 2016
- **Other identifiers:** Medicare PIN 047659 (PA); Medicaid 001864024 (PA)
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Source: [NPI Profile](https://npiprofile.com/npi/1316076961) · Data from the CMS NPPES public registry.