MEDICARE: EVANGELICAL MEDICAL SERVICES ORGANIZATION

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	207RB0002X	Obesity Medicine (Internal Medicine) Physician
2	207V00000X	Obstetrics & Gynecology Physician
3	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician
4	207LP2900X	Pain Medicine (Anesthesiology) Physician	PA
5	2084N0400X	Neurology Physician	PA
6	207RE0101X	Endocrinology, Diabetes & Metabolism Physician
7	208800000X	Urology Physician
8	207RR0500X	Rheumatology Physician	PA
9	207RC0000X	Cardiovascular Disease Physician
10	207X00000X	Orthopaedic Surgery Physician
11	207RC0200X	Critical Care Medicine (Internal Medicine) Physician
12	208M00000X	Hospitalist Physician	PA
13	207Y00000X	Otolaryngology Physician
14	207RN0300X	Nephrology Physician
15	208600000X	Surgery Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	CA5965	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	118438703	OTHER	PA	DEPARTMENT OF LABOR
2	2024199	OTHER	PA	BLUE SHIELD
3	50062131	OTHER	PA	CAPITAL BLUE CROSS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205928967
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVANGELICAL MEDICAL SERVICES ORGANIZATION

Provider Business Mailing Address
First Line	:	601 MEMORY LN
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-2231
Country	:	US
Telephone Number	:	717-851-1405
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 HOSPITAL DR STE 100
Second Line	:
City	:	LEWISBURG
State	:	PA
Zip	:	17837-9394
Country	:	US
Telephone Number	:	570-524-5056
Fax Number	:

Authorized Official
Title or Position	:	SENIOR VICE PRESIDENT/PRESIDENT
Name	:	ALLEN FASNACHT
Credential	:
Telephone Number	:	570-522-2807

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	03/02/2026

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1407824329 — KIMBERLY A PESARCHICK PA-C
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1477521391 — TODD M STEFAN MD
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Directions to “EVANGELICAL MEDICAL SERVICES ORGANIZATION ” Practice Location

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