Excela Health Physician Practices, Inc.
Organization Active NPI Family Medicine Physician · West Newton, PA
NPI 1073609236 · NPPES record last updated Aug 23, 2011
Key facts
- NPI
- 1073609236
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD041300L (PA)
- Legal business name
- EXCELA HEALTH PHYSICIAN PRACTICES, INC.
- Practice address
- 115 S 2ND St
West Newton, PA 15089-1357 - Phone
- (724) 872-5252
- Fax
- (724) 872-5501
- NPI assigned
- Oct 5, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- EXCELA HEALTH HOLDING COMPANY
Authorized official
- Name
- Kirk L. Miller
- Title
- VP, Phys Serv & Exec Dir, Ehpp
- Phone
- (724) 830-8500
Practitioners 14
-
Saghir Ahmad, MD
-
Ruth A Dilello, CRNA
-
Diane S Fair, CRNA
-
Syed Shabbir Haider, M.D.
-
Venkata Anand Komanduri, M.D.
-
Paul James Myers, DO
-
Owais Rahim, M.D.
-
Cynthia J Donatelli, CRNA
-
Edwin Shadzeka, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040322001393 | PA | Part B Supplier - Clinic/Group Practice | 6204737117 |
Receives reassigned benefits from 767 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
Locations
8775 Norwin Ave
North Huntingdon, PA 15642
Phone (724) 527-8031
115 S 2nd St
West Newton, PA 15089
Phone (724) 872-0930
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | MD041300L | PA | Yes |
Addresses
Primary practice location
115 S 2ND St
West Newton, PA 15089-1357
Mailing address
115 S 2ND St
West Newton, PA 15089-1357
Phone (724) 872-5252
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0015621860069 | Medicaid | PA |
Other names
- Excela Health West Newton Family Medicine
Other providers in West Newton, PA
- Christopher John Barr
- Emily E Bell
- Cole Zusmer Chiropractic
- James T Cole
- Thomas C Cole
- Excela Health Physician Practices, Inc.
- Giant Eagle Inc
- Good Day Sunshine Counseling LLC
- Hearing Professionals of America LLC
- Megan Hedglen
All providers in West Newton, PA · Family Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.