Organization Active NPI

Physicianspecialtynetwork PLLC

  • Pulmonary Disease Physician
  • Erie, PA
National Provider Identifier
1043946445
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
PHYSICIANSPECIALTYNETWORK PLLC
Practice address
6073 Volkman Rd
Erie, PA 16506-6501
Phone
(814) 490-4445
NPI assigned
Jul 27, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Authorized official

Name
Craig Wilczynski
Title
Practice Administrator
Phone
(814) 490-4445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

6073 Volkman Rd
Erie, PA 16506-6501

Mailing address

6073 Volkman Rd
Erie, PA 16506-6501
Phone (814) 490-4445

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221005000079 PA Part B Supplier - Clinic/Group Practice 7911383567 Receives reassigned benefits from 2 practitioners
Practice locations: Erie, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658880000000",
    "number": "1043946445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6073 VOLKMAN RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165066501",
            "telephone_number": "814-490-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6073 VOLKMAN RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165066501",
            "telephone_number": "814-490-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANSPECIALTYNETWORK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A",
        "authorized_official_last_name": "WILCZYNSKI",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "814-490-4445"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; 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.