Roland Jean Crevecoeur Jr., M.D

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD-419870 Issued in PA

Practice address

1800 N Juniata St
Hollidaysburg, PA 16648-1997

Phone

(814) 695-1675

Fax

(814) 695-0632

NPI assigned

Sep 16, 2006

Last updated

Jan 20, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nason Physician Practices LLC

  dba Nason OBGYN

  • Obstetrics & Gynecology Physician
  • Roaring Spring, PA
  • NPI 1306236609
  Medicare reassignment NPD
• Pennsylvania Department of Human Services

  dba Ebensburg Center

  • Intellectual Disabilities Intermediate Care Facility
  • Ebensburg, PA
  • NPI 1154304483
  Medicare reassignment NPD
• Nason Physician Practices LLC

  dba Nason Physician Practice-ER

  • Emergency Medicine Physician
  • Roaring Spring, PA
  • NPI 1346752284

  Internal Medicine

  NPD
• Pennsylvania Department of Public Welfare

  dba Allentown State Hospital

  • Psychiatric Hospital
  • Allentown, PA
  • NPI 1386626919
  NPD
• Upmc Altoona

  • General Acute Care Hospital
  • Altoona, PA
  • NPI 1649278730
  NPD (past)
• Windber Hospital, Inc.

  dba Windber Medical Center

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1003912031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 N JUNIATA ST",
            "address_2": "P O BOX 632",
            "city": "HOLLIDAYSBURG",
            "state": "PA",
            "postal_code": "166481997",
            "telephone_number": "814-695-1675",
            "fax_number": "814-695-0632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N JUNIATA ST",
            "city": "HOLLIDAYSBURG",
            "state": "PA",
            "postal_code": "166481997",
            "telephone_number": "814-695-1675",
            "fax_number": "814-695-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREVECOEUR",
        "first_name": "ROLAND",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD419870",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD-419870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEGACY PIN",
            "identifier": "110094",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR PIN",
            "identifier": "P00432632",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001922333",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cecilia M Cortes Rogers, M.D.
• Miranda Nichole Coury
• Victoria Elizabeth Crabtree
• Wendy Lane Crayosky, L.C.S.W
• Amber Creamer
• Austin D Cunningham
• Bailey Dale
• Michael J Davies, MD
• Valarie Davison, MS, CCC-SLP
• Dennis G Ridenour D.C. PC

• Pediatrics Physician in Hollidaysburg, PA
• Providers in Hollidaysburg, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.