NPIMap

Individual provider Active NPI

Jay E Endres, MD

  • Family Medicine Physician
  • Warren, PA
National Provider Identifier
1073581948
Registry record updated Feb 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD039470L Issued in PA
Practice address
12 Elm St
Warren, PA 16365
Phone
(814) 723-3520
Fax
(814) 726-2988
NPI assigned
Mar 8, 2006
Last updated
Feb 3, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD039470L PA Primary

Addresses

Primary practice location

12 Elm St
Warren, PA 16365

Mailing address

12 Elm St
Warren, PA 16365
Phone (814) 723-3520

Other identifiers 3

IdentifierTypeStateIssuer
001022675MedicaidPA
040600OtherPAHIGHMARK
422220OtherPAHIGHMARK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060329000323 PA Practitioner - Family Practice 8628086964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12 Elm St
Warren, PA 16365-2808
Phone (814) 723-3520

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
23.82 of 100Reported as individual
Quality
15
Improvement activities
0
Cost
42.74

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD039470LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jay E Endres MDPC Family Medicine CurrentSince Jan 21, 1985 Accepting new patients
HCF of Warren, Inc. Past Accepting new patients
Kinzua PA Opco LLC Past Accepting new patients
Board of Directors of the Rouse Estate Past Accepting new patients
Guardian Elder Care at Warren LLC Past Accepting new patients

Locations

12 Elm St
Warren, PA 16365
Phone (814) 452-8300

205 Water St
Warren, PA 16365
Phone (814) 726-0820

701 Rouse Ave
Youngsville, PA 16371
Phone (814) 563-7565

Ownership & related parties

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Board of Directors of the Rouse EstateYoungsville, PA, CCN 395609 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 30, 1998
Mar 13, 2025
Kinzua Nursing and RehabWarren, PA, CCN 395363 Skilled nursing facility Adp of the SNF Dec 20, 2024

Owned or controlled facilities with NPI records 3

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

Organizations & group practices 5

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1073581948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 ELM ST",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "16365",
            "telephone_number": "814-723-3520",
            "fax_number": "814-726-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 ELM ST",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "16365",
            "telephone_number": "814-723-3520",
            "fax_number": "814-726-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDRES",
        "first_name": "JAY",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD039470L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001022675",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "040600",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "422220",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, PA

Sources for this page

Verify at the official NPI Registry.