Brookville Hospital
Organization Active NPI Family Medicine Physician · Brookville, PA
NPI 1083762876 · NPPES record last updated Feb 7, 2017
Key facts
- NPI
- 1083762876
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- BROOKVILLE HOSPITAL
- Practice address
- 22 Industrial Park Rd
Brookville, PA 15825-7228 - Phone
- (814) 849-0990
- Fax
- (814) 849-0992
- NPI assigned
- Jan 8, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- PENN HIGHLANDS HEALTHCARE
Authorized official
- Name
- Mrs. Julianne Peer
- Title
- President/Authorized Official
- Phone
- (814) 849-1461
Parent organization (reported in NPPES) 1
Owners & managing parties with NPI records 2
-
Donald E. Conrad, D.O.
-
James Edward Devlin, M.D.
Other NPIs on the same Medicare enrollment 3
Member of 1
Related certifications (CCN) 6
Practitioners 2
-
Ahmad Nabatchi, MD
-
Lana J Smith, C.R.N.P
Affiliated clinicians 239
-
Emmanuel A Agwa, MD
-
Lara M Allman, D.P.M.
-
Jayaseelan Ambrose, M.D.
-
Beth Ann Aughenbaugh, CRNP
-
Indraneel Banerjee, M.D.
-
John Samuel Banerji, MD, M.CH
-
Sandeep Bansal, MD
-
Tyler D Beers, PA
-
Morgan Diane Beimel, PA-C
-
Kate Belfiore, PA-C
-
Joel A Bezek, MD
-
Naomi Marie Blackburn, PA-C
-
Muir Blochberger, PA-C
-
Marissa Virginia Blose, PA-C
-
Steven Bonebrake, D.O.
-
Emily Rae Brazinski, CRNP
-
Jamie L Bush, CRNP
Medicare Care Compare: Hospital
- Listed as
- Penn Highlands Brookville
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Hospital certification: CCN 391312
- Legal name
- BROOKVILLE HOSPITAL
- Doing business as
- PENN HIGHLANDS BROOKVILLE
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Jan 1, 2006
- Last certification
- Feb 1, 2024
- Beds
- 35
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Apr 13, 1915 in PA
- Enrollment address
- 100 Hospital Rd
Brookville, PA 15825-1367
All disclosed owners & managing parties 24
| Name | Role | Since | Share |
|---|---|---|---|
| Douglas Winner |
Corporate Officer |
Aug 12, 2024 | |
| Jourdan D Strishock |
W-2 Managing Employee |
Aug 1, 2021 | |
| Russell E Cameron |
Corporate Officer |
Jul 1, 2016 | |
| Penn Highlands Healthcare, Inc. |
Other | Oct 1, 2011 | 100% |
| Robert W O'Leary |
Corporate Director |
Jul 1, 2021 | |
| Trina L Johnson |
Corporate Director |
Oct 21, 2022 | |
| Edward Yahner |
Corporate Director |
Jul 1, 2025 | |
| Joanne Ryan |
Corporate Director |
Jul 1, 2022 | |
| David Lezzer |
Corporate Director |
Jul 1, 2021 | |
| James E Devlin |
Corporate Director |
Jul 1, 2022 | |
| Carlyn Belczyk |
Corporate Director |
Oct 1, 2021 | |
| Dubois Regional Medical Center |
Operational/Managerial Control | Sep 26, 2007 | |
| Samuel Lewis |
Corporate Director |
Feb 1, 2021 | |
| Richard L Pfingstler |
Corporate Director |
Jul 1, 2021 | |
| Donald E Conrad |
Corporate Director |
Jul 1, 2021 | |
| Scott H Foradora |
Corporate Director |
Jul 1, 2020 | |
| Mark Norman |
Corporate Officer |
Jul 1, 2016 | |
| W-2 Managing Employee | Jul 1, 2016 | ||
| William H Young |
Corporate Director |
Jul 1, 2021 | |
| Mark McGinley |
Corporate Director |
Oct 1, 2021 | |
| James B Ryan |
Corporate Director |
Jul 1, 2020 | |
| John S Sutika |
Corporate Director |
Jul 1, 2025 | |
| Brian S Kline |
Corporate Officer |
Jul 1, 2024 | |
| W-2 Managing Employee | Jul 1, 2024 | ||
| Steven M Fontaine |
Corporate Officer |
Jul 1, 2016 | |
| Julianne Peer |
Corporate Officer |
Aug 12, 2013 | |
| W-2 Managing Employee | Feb 6, 2006 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060206000170 | PA | Part a Provider - Critical Access Hospital | 3072579598 |
Receives reassigned benefits from 136 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Brookville, PA |
National Provider Directory
- Part of
- Penn Highlands Healthcare
Locations
22 Industrial Park Rd
Brookville, PA 15825
Phone (814) 849-0990
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker |
104100000X | |||
| Family Medicine Physician |
207Q00000X | Yes | ||
| Rural Health Clinic/Center | 261QR1300X | PA |
Addresses
Primary practice location
22 Industrial Park Rd
Brookville, PA 15825-7228
Mailing address
100 Hospital Rd
Brookville, PA 15825-1367
Phone (814) 849-2312
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000869472 | Other | PA | BLUE SHIELD |
Other names
- ALLEGHENY HEALTH CENTER
Other providers in Brookville, PA
- Brookville Area School District
- Brookville Chiropractic & Rehabilitation Center, LLC
- Brookville Dental PC
- Brookville Emergency Group PC
- Brookville Hospital
- Brookville Hospital
- Brookville Hospital
- Brookville Hospital
- Brookville Hospital
- Brookville Hospital
All providers in Brookville, 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 Feb 7, 2017. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.