WELLSPAN FAMILY MEDICINE - WEST CORNWALL
NPI 1639620164
Family Medicine in Lebanon, PA
About Wellspan Family Medicine - West Cornwall NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WELLSPAN FAMILY MEDICINE - WEST CORNWALL (NPI 1639620164) is a healthcare organization registered as a family medicine in Lebanon, Pennsylvania and active in the NPI registry since October 2016. The organization holds a CLIA Waiver certificate valid through May 30, 2028 and lists Christina Moon, Supervisor-verification Services, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
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 - West Cornwall is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3,072Medicare enrollment records show 3,072 clinicians reassign Medicare billing to Wellspan Family Medicine - West Cornwall, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 223 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 65
Nearest to this location (20)
See all 3,072Lebanon, PA 17042
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 39D0958599
Wellspan Fam Med West Cornwall · Lebanon, PAFrequently 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 1639620164. It was assigned to this organization in the NPPES registry on October 19, 2016. The provider is doing business as Wellspan Family Medicine - West Cornwall.
Where is Wellspan Medical Group located?
Wellspan Medical Group is located at 101 Fairview Cir, Lebanon, PA 17042. The listed phone number is (717) 279-7303.
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, 2 practice at this address and 223 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 39D0958599) is associated with this NPI, valid through May 30, 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 October 20, 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 - West Cornwall · NPI 1639620164
Family Medicine organization in Lebanon, Pennsylvania. Organization record, active in the CMS NPPES registry since October 19, 2016.
## Identity
- **NPI:** 1639620164 (Entity type: Organization)
- **Enumerated:** October 19, 2016
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Wellspan Medical Group
- **Organization subpart:** No
- **Authorized official:** Christina Moon, SUPERVISOR-VERIFICATION SERVICES
## Practice location
- **Address:** 101 FAIRVIEW CIR, Lebanon, PA 17042-9581
- **Phone:** (717) 279-7303 · **Fax:** (717) 279-7471
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3,072 clinicians in 65 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (658), Certified Registered Nurse Anesthetist (CRNA) (284), Family Practice (275); 2 practice at this address and 223 within 10 miles; [full list](https://npiprofile.com/npi/1639620164/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 20, 2016
- **Other identifiers:** Medicare PIN 117038FLT (PA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1639620164) · Data from the CMS NPPES public registry.