NPIMap

Organization Active NPI

Excela Health Physician Practices, Inc.

  • Family Medicine Physician
  • West Newton, PA
National Provider Identifier
1073609236
Registry record updated Aug 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD041300L Issued in 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
Last updated
Aug 23, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
EXCELA HEALTH HOLDING COMPANYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 23, 2011

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

Authorized official

Name
Kirk L. Miller
Title
VP, Phys Serv & Exec Dir, Ehpp
Phone
(724) 830-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MD041300L PA Primary

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 names 1

  • Excela Health West Newton Family Medicine Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

National Provider Directory

Locations

115 S 2nd St
West Newton, PA 15089
Phone (724) 872-0930

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314057600000",
    "number": "1073609236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S 2ND ST",
            "city": "WEST NEWTON",
            "state": "PA",
            "postal_code": "150891357",
            "telephone_number": "724-872-5252",
            "fax_number": "724-872-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S 2ND ST",
            "city": "WEST NEWTON",
            "state": "PA",
            "postal_code": "150891357",
            "telephone_number": "724-872-5252",
            "fax_number": "724-872-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELA HEALTH PHYSICIAN PRACTICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXCELA HEALTH HOLDING COMPANY",
        "enumeration_date": "2006-10-05",
        "last_updated": "2011-08-23",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "VP, PHYS SERV & EXEC DIR, EHPP",
        "authorized_official_telephone_number": "724-830-8500"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD041300L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excela Health West Newton Family Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in West Newton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; 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.