MEDICARE: KRISTEN AGNES WASSEL P.A.-C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	MA050778	PA
2	363AM0700X	Medical Physician Assistant	MA050778	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	970022170	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	1958792	OTHER	HIGHMARK BLUE SHIELD
2	P3176072	OTHER	OXFORD HEALTH PLANS
3	50047062	OTHER	CAPITAL BLUE CROSS
4	328920	OTHER	HEALTHAMERICA/HEALTHASSUR
5	50047062	OTHER	KEYSTONE HEALTH CENTRAL

General Provider Information

NPI Number	:	1053319855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN AGNES WASSEL P.A.-C.

Provider Business Mailing Address
First Line	:	2793 GERYVILLE PIKE
Second Line	:
City	:	PENNSBURG
State	:	PA
Zip	:	18073-2306
Country	:	US
Telephone Number	:	267-424-8005
Fax Number	:

Provider Business Practice Location Address
First Line	:	2793 GERYVILLE PIKE
Second Line	:
City	:	PENNSBURG
State	:	PA
Zip	:	18073-2306
Country	:	US
Telephone Number	:	267-424-8005
Fax Number	:	610-807-0366

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	08/13/2025

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Directions to “ KRISTEN AGNES WASSEL P.A.-C.” Practice Location

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