NPIMap

Organization Active NPI

Windber Hospital, Inc.

  • Family Medicine Physician
  • Johnstown, PA
National Provider Identifier
1104872936
Registry record updated Jun 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD434855 Issued in PA
Legal business name
WINDBER HOSPITAL, INC.
Practice address
1511 Scalp Ave
Johnstown, PA 15904-3315
Phone
(814) 254-4207
Fax
(814) 254-4733
NPI assigned
May 25, 2006
Organization subpart
Yes
Parent organization
WINDBER HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 10, 2015

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

Authorized official

Name
Tom Kurtz
Title
President / Ceo
Phone
(814) 467-3702

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X MD060939L PA
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X MD434855 PA Primary

Addresses

Primary practice location

1511 Scalp Ave
Johnstown, PA 15904-3315

Mailing address

1511 Scalp Ave
Johnstown, PA 15904-3315
Phone (814) 254-4207

Other identifiers 2

IdentifierTypeStateIssuer
1794402OtherPAHIGHMARK
1007703740019MedicaidPA

Other names 1

  • Windber Care Physicians Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060727000277 PA Part B Supplier - Hospital Department(S) 9234187576 Receives reassigned benefits from 14 practitioners
Practice locations: Sidman, PA; Windber, PA; Johnstown, PA

Other NPIs with the same Medicare PAC ID 7

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D1006065Windber Care Physicians1511 Scalp Avenue, Johnstown, PA 15904Provider-performed microscopyNov 5, 2026

National Provider Directory

National Provider Directory
Tax ID family
Windber Hospital8 organizations share this tax ID, including this one
Part of
Windber Hospital

Other organizations with this tax ID 7

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

Locations

1511 Scalp Ave
Johnstown, PA 15904
Phone (814) 254-4207

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
Regional Hospice at WindberWindber, PA, CCN 391541 Hospice Operational/Managerial Control (100%) Jul 1, 1990

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 42

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433894400000",
    "number": "1104872936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 SCALP AVE",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043315",
            "telephone_number": "814-254-4207",
            "fax_number": "814-254-4733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 SCALP AVE",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043315",
            "telephone_number": "814-254-4207",
            "fax_number": "814-254-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDBER HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WINDBER HOSPITAL, INC.",
        "enumeration_date": "2006-05-25",
        "last_updated": "2015-06-10",
        "status": "A",
        "authorized_official_last_name": "KURTZ",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "814-467-3702"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD060939L",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD434855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "1794402",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007703740019",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Windber Care Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.