Jane Gagne, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD053735L Issued in PA

Practice address

274 3Rd St
Suite 100
Beaver, PA 15009-2333

Phone

(724) 774-5700

Fax

(724) 774-5175

NPI assigned

May 1, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208390400000",
    "number": "1003873241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 AUTUMN ST",
            "address_2": "SUITE 101",
            "city": "ALIQUIPPA",
            "state": "PA",
            "postal_code": "150011301",
            "telephone_number": "724-375-3199",
            "fax_number": "724-375-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 3RD ST",
            "address_2": "SUITE 100",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "150092333",
            "telephone_number": "724-774-5700",
            "fax_number": "724-774-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNE",
        "first_name": "JANE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2008-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD053735L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015218350003",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0144016",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "786537",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC",
            "identifier": "204249",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Friendship Operations LLC
• Friendship Ridge
• Sue Ann Fultz, MA., LBS
• Elizabeth Ann Fusco, CRNP
• Michael William Gabriele, M.D.
• Megan Nicole Gallo, CRNP
• Leonard Ira Ganz, MD
• Ellen Garibaldi, M.D.
• Alexa Garrison, MD
• Dominic Garuccio, CRNA

• Family Medicine Physician in Beaver, PA
• Providers in Beaver, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.