SUSQUEHANNA PHYSICIAN SERVICES
NPI 1477793172
Internal Medicine - Nephrology in Williamsport, PA
About Susquehanna Physician Services NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SUSQUEHANNA PHYSICIAN SERVICES (NPI 1477793172) is a healthcare organization registered as a nephrology in Williamsport, Pennsylvania and active in the NPI registry since February 2009. The organization lists Melissa Davis, Vp/coo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Susquehanna Physician Services is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
10Medicare enrollment records show 10 clinicians reassign Medicare billing to Susquehanna Physician Services, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 6 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 3
Clinicians, nearest first (10)
Source: 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 Susquehanna Physician Services's NPI number?
The NPI number for Susquehanna Physician Services is 1477793172. It was assigned to this organization in the NPPES registry on February 20, 2009.
Where is Susquehanna Physician Services located?
Susquehanna Physician Services is located at 1201 Grampian Blvd Ste 1A, Williamsport, PA 17701. The listed phone number is (570) 326-8080.
What is Susquehanna Physician Services's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.
Is Susquehanna Physician Services enrolled in Medicare?
Yes. Susquehanna Physician Services is registered in the Medicare PECOS enrollment system.
When is Susquehanna Physician Services's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Pennsylvania, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Susquehanna Physician Services?
According to the CMS Revalidation Reassignment List (October 2026 release), 10 clinicians in 3 Medicare specialties reassign their Medicare billing to Susquehanna 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 (5), Nephrology (4) and Family Practice (1). Of these, 3 practice at this address and 6 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 Susquehanna Physician Services was last updated on April 24, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Susquehanna Physician Services · NPI 1477793172
Nephrology organization in Williamsport, Pennsylvania. Organization record, active in the CMS NPPES registry since February 20, 2009.
## Identity
- **NPI:** 1477793172 (Entity type: Organization)
- **Enumerated:** February 20, 2009
- **Primary specialty:** Internal Medicine - Nephrology · taxonomy 207RN0300X
- **Organization subpart:** No
- **Authorized official:** Melissa Davis, VP/COO
## Practice location
- **Address:** 1201 GRAMPIAN BLVD STE 1A, Williamsport, PA 17701-1965
- **Phone:** (570) 326-8080 · **Fax:** (570) 326-2733
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Pennsylvania, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 10 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (5), Nephrology (4), Family Practice (1); 3 practice at this address and 6 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 24, 2020
- **Other identifiers:** Medicaid 0017300760171 (PA); Other 2089118 (PA)
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Source: [NPI Profile](https://npiprofile.com/npi/1477793172) · Data from the CMS NPPES public registry.