NPIMap

Organization Active NPI

Titusville Area Hospital

  • Emergency Medicine Physician
  • Titusville, PA
National Provider Identifier
1013012335
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
TITUSVILLE AREA HOSPITAL
Practice address
406 W Oak St
Titusville, PA 16354-1499
Phone
(814) 827-1851
Fax
(814) 827-2907
NPI assigned
Sep 13, 2006
Reactivated
Oct 16, 2023
Last updated
Oct 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Authorized official

Name
Jill A. Neely
Title
Cfo
Phone
(814) 827-1851

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

406 W Oak St
Titusville, PA 16354-1499

Mailing address

406 W Oak St
Titusville, PA 16354-1499
Phone (814) 827-1851

Other names 1

  • Titusville Area Hospital Emergency Medicine Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040312000428 PA Part B Supplier - Clinic/Group Practice 8022907575 Receives reassigned benefits from 19 practitioners
Practice locations: Titusville, PA

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Titusville Hosp Lab9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697414400000",
    "number": "1013012335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 W OAK ST",
            "city": "TITUSVILLE",
            "state": "PA",
            "postal_code": "163541499",
            "telephone_number": "814-827-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 W OAK ST",
            "city": "TITUSVILLE",
            "state": "PA",
            "postal_code": "163541499",
            "telephone_number": "814-827-1851",
            "fax_number": "814-827-2907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TITUSVILLE AREA HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "deactivation_date": "2021-07-08",
        "reactivation_date": "2023-10-16",
        "status": "A",
        "authorized_official_last_name": "NEELY",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "814-827-1851"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Titusville Area Hospital Emergency Medicine",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Titusville Area Hospital Emergency Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Titusville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.