NPIMap

Organization Active NPI

Brookville Hospital

Doing business as Emergency Room

  • Emergency Medicine Physician
  • Brookville, PA
National Provider Identifier
1063560852
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
BROOKVILLE HOSPITAL
Doing business as
Emergency Room
Practice address
100 Hospital Rd
Brookville, PA 15825-1367
Phone
(814) 849-2312
Fax
(814) 849-1822
NPI assigned
Jan 8, 2007
Last updated
Mar 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2008

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

Authorized official

Name
Mrs. Julianne Peer
Title
Cfo
Phone
(814) 849-1408

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X PA Primary

Addresses

Primary practice location

100 Hospital Rd
Brookville, PA 15825-1367

Mailing address

100 Hospital Rd
Brookville, PA 15825-1367
Phone (814) 849-2312

Other identifiers 1

IdentifierTypeStateIssuer
000856073OtherPABLUE SHIELD

Other names 1

  • EMERGENCY ROOM Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050428000025 PA Part B Supplier - Clinic/Group Practice 3072579598 Receives reassigned benefits from 49 practitioners
Practice locations: Brookville, PA

Other NPIs with the same Medicare PAC ID 10

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

National Provider Directory

National Provider Directory
Tax ID family
Brookville Clinic Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Penn Highlands Jefferson ManorBrookville, PA, CCN 395626 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 51

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 51

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205884800000",
    "number": "1063560852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL RD",
            "city": "BROOKVILLE",
            "state": "PA",
            "postal_code": "158251367",
            "telephone_number": "814-849-2312",
            "fax_number": "814-849-1822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL RD",
            "city": "BROOKVILLE",
            "state": "PA",
            "postal_code": "158251367",
            "telephone_number": "814-849-2312",
            "fax_number": "814-849-1822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKVILLE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2008-03-19",
        "status": "A",
        "authorized_official_last_name": "PEER",
        "authorized_official_first_name": "JULIANNE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "814-849-1408",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000856073",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EMERGENCY ROOM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brookville, PA

Sources for this page

Verify at the official NPI Registry.