JODI L KNEISLY CRNP
NPI 1790430502
Nurse Practitioner - Gerontology in State College, PA
About Jodi L Kneisly Crnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JODI L KNEISLY CRNP (NPI 1790430502) is an individual gerontology provider in State College, Pennsylvania, licensed in Pennsylvania (RN556458) and active in the NPI registry since February 2022. She is enrolled in Medicare PECOS and maintains a secondary practice location in Pittsburgh.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jodi L Kneisly Crnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jodi Kneisly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Ashland, PA 17921
- Reassigned Medicare billing, Pennsylvania enrollment
- Medicare enrollment name: St Lukes Physician Group Inc
- 2,851 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 16803 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
STATE COLLEGE, PA 16803
STATE COLLEGE, PA 16803
STATE COLLEGE, PA 16803
STATE COLLEGE, PA 16803
STATE COLLEGE, PA 16803
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 Jodi Kneisly's NPI number?
The NPI number for Jodi Kneisly is 1790430502. It was assigned to this individual provider in the NPPES registry on February 21, 2022.
Where is Jodi Kneisly located?
Jodi Kneisly practices at 330 Innovation Blvd Fl 2, State College, PA 16803. The listed phone number is (888) 731-8994.
What is Jodi Kneisly's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.
Is Jodi Kneisly enrolled in Medicare?
Yes. Jodi Kneisly is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jodi Kneisly's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jodi Kneisly reassigns Medicare benefits to St Luke's Physician Group Inc (Ashland, PA). The 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 Jodi Kneisly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jodi Kneisly was last updated on May 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.
# Jodi L Kneisly, CRNP · NPI 1790430502
Gerontology physician in State College, Pennsylvania. Individual provider, active in the CMS NPPES registry since February 21, 2022.
## Identity
- **NPI:** 1790430502 (Entity type: Individual)
- **Enumerated:** February 21, 2022
- **Primary specialty:** Nurse Practitioner - Gerontology · taxonomy 363LG0600X
- **State license:** RN556458 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 330 INNOVATION BLVD FL 2, State College, PA 16803-6611
- **Phone:** (888) 731-8994
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** St Luke's Physician Group Inc (NPI 1134487119, Ashland, PA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 13, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1790430502) · Data from the CMS NPPES public registry.