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SUSQUEHANNA HEALTH MEDICAL GROUP
NPI 1548289689
Pediatrics in Williamsport, PA

Active since July 19, 2006CLIA 39D1089385 · Waiver
700 HIGH STREET, WILLIAMSPORT, PA 17701(570) 321-2810(570) 321-2811 Get Directions Write a Review

NPPES record last updated: October 20, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Susquehanna Health Medical Group NPPES

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

SUSQUEHANNA HEALTH MEDICAL GROUP (NPI 1548289689) is a healthcare organization registered as a pediatrics in Williamsport, Pennsylvania and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through September 18, 2026 and lists Melissa Davis, Vp/coo, as its authorized official.

NPPES Registry Identity

NPI1548289689
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameSUSQUEHANNA PHYSICIAN SERVICES
Location Address700 HIGH STREETWilliamsport, PA 17701-3198
Mailing Address1201 Grampian BlvdWilliamsport, PA 17701-1900
Phone(570) 321-2810
Fax(570) 321-2811
Organization SubpartNo
Authorized OfficialMelissa DavisVp/coo · (570) 320-7696
Enumeration DateJuly 19, 2006
Last NPPES UpdateOctober 20, 2015
✔ NPI 1548289689 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedHospitalistTaxonomy 208M00000X
Also ListedNurse Practitioner · PediatricsTaxonomy 363LP0200X
700 HIGH STREET, Williamsport, PA 17701
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Other Names 1

Doing Business AsSusquehanna Health Medical Group

Other Identifiers 2

Other1611202PA · Highmark Blue Shield
Medicaid0017300760208PA

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

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 39D1089385

Susquehanna Health Pediatrics · Williamsport, PA
Active · expires Sep 18, 2026
CLIA Number39D1089385
Laboratory TypePhysician Office
Certificate Effective DateSeptember 19, 2024
Certificate Expiration DateSeptember 18, 2026
Laboratory DirectorDr. Ashley Pence
Laboratory Phone(570) 321-2810
Laboratory LocationSusquehanna Health Pediatrics700 High Street, 9th Floor, Williamsport, PA 17701
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TIMOTHY EDWARD WIRTH PHARMD
Pharmacist
700 HIGH STREET, PHARMACY DEPARTMENT
WILLIAMSPORT, PA 17701
Lycoming County (570) 321-3083
SUSQUEHANNA PHYSICIAN SERVICES
Internal Medicine (Pulmonary Disease)
700 HIGH STREET
WILLIAMSPORT, PA 17701
Lycoming County (570) 321-3580
SUSQUEHANNA PHYSICIAN SERVICES
Internal Medicine (Gastroenterology)
700 HIGH STREET
WILLIAMSPORT, PA 17701
Lycoming County (570) 321-3454
SUSQUEHANNA PHYSICIAN SERVICES
Internal Medicine (Infectious Disease)
700 HIGH STREET
WILLIAMSPORT, PA 17701
Lycoming County (570) 321-2181
UPMC WILLIAMSPORT
Clinic/Center (Ambulatory Surgical)
700 HIGH STREET
WILLIAMSPORT, PA 17701
Lycoming County (570) 321-1000
DONNA L MENIG CRNP
Nurse Practitioner (Gerontology)
700 HIGH STREET
WILLIAMPSORT, PA 17701
Lycoming County (570) 321-3580
JED NIEVES CRNP
Nurse Practitioner
700 HIGH STREET
WILLIAMSPORT, PA 17701
Lycoming County (570) 321-2020
DANA CORRINE POLETO CRNP
Nurse Practitioner (Gerontology)
700 HIGH STREET
WILLIAMSPORT, PA 17701
Lycoming County (570) 321-3580

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 1548289689. It was assigned to this organization in the NPPES registry on July 19, 2006. The provider is doing business as Susquehanna Health Medical Group.

Where is Susquehanna Physician Services located?

Susquehanna Physician Services is located at 700 High Street, Williamsport, PA 17701. The listed phone number is (570) 321-2810.

What is Susquehanna Physician Services's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Susquehanna Physician Services hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D1089385) is associated with this NPI, valid through September 18, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Susquehanna Physician Services was last updated on October 20, 2015. 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.