NPIMap

Organization Active NPI

Oasis Lifecare LLC

  • Psychiatry Physician
  • State College, PA
National Provider Identifier
1013398130
Registry record updated Jul 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
OASIS LIFECARE LLC
Practice address
1520 Martin St
State College, PA 16803-3058
Phone
(814) 883-9949
NPI assigned
Jun 15, 2015
Last updated
Jul 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2015

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

Authorized official

Name
Jason M Lieb
Title
Executive Officer
Phone
(814) 883-9949

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

1520 Martin St
State College, PA 16803-3058

Mailing address

1520 Martin St
State College, PA 16803-3058

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160204000454 PA Part B Supplier - Clinic/Group Practice 2860796323 Receives reassigned benefits from 17 practitioners
Practice locations: State College, PA

National Provider Directory

National Provider Directory

Locations

1520 Martin St
State College, PA 16803
Phone (814) 231-1220

1526 Martin St
State College, PA 16803
Phone (814) 237-0001

1951 Pine Hall Rd
Ste 225
State College, PA 16801
Phone (814) 237-0001

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": "1434326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437350400000",
    "number": "1013398130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 MARTIN ST",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168033058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 MARTIN ST",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168033058",
            "telephone_number": "814-883-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OASIS LIFECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-15",
        "last_updated": "2015-07-20",
        "status": "A",
        "authorized_official_last_name": "LIEB",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "814-883-9949"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; 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.