NPIMap

Organization Active NPI

Titusville Area Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Titusville, PA
National Provider Identifier
1104921428
Registry record updated Jun 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
200901 Issued in PA
Legal business name
TITUSVILLE AREA HOSPITAL
Practice address
406 West Oak Street
Titusville, PA 16354
Phone
(814) 827-8923
Fax
(814) 827-3099
NPI assigned
Sep 13, 2006
Last updated
Jun 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2025

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

Authorized official

Name
Jill A Neely
Title
Cfo
Phone
(814) 827-8923

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 200901 PA Primary

Addresses

Primary practice location

406 West Oak Street
Titusville, PA 16354

Mailing address

406 West Oak Street
Titusville, PA 16354
Phone (814) 827-8923

Other names 1

  • Titusville Area Hospital Swing Bed Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220807000050 PA Part A Provider - Critical Access Hospital 8022907575 Practice locations: Titusville, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104921428. Details of each certification follow.

Hospital certification: CCN 39Z314

Legal name
TITUSVILLE AREA HOSPITAL
Organization structure
CorporationNon-profit
Enrollment address
406 W Oak St
Titusville, PA 16354-1404
Hospital Swing-Bed Unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 15

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

View all 15

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Lee M Clinton Individual OtherBoard Member Jan 1, 2021
Lawrence Fledderman Individual Corporate DirectorBoard Member Jan 31, 2012
Scott J McAllister Individual OtherBoard Member Jan 1, 2021
Patricia Walker Individual OtherBoard Member Jan 1, 2021
Jason Reagle Individual OtherBoard Member Jan 1, 2021
Mark Mehlenbacher Individual OtherBoard Member Jan 1, 2021
Richard Carr Individual Corporate DirectorBoard Member May 1, 2014
Jill a Neely Individual Corporate OfficerVP Fiscal Cfo Aug 7, 2007
W-2 Managing EmployeeVP Fiscal Cfo Aug 7, 2007
Operational/Managerial ControlCfo Aug 7, 2007
Meadville Medical Center Organization, Meadville, PA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2015
Brian S Nageotte Individual OtherBoard Member Jan 1, 2021
Kenneth Winger Individual OtherBoard Member Jan 1, 2021
Joseph Carter Individual OtherBoard Member Jan 1, 2021
Renato Suntay Individual Corporate OfficerCorporate VP & Cfo Oct 1, 2015
Stephen C Coleman Individual Corporate DirectorBoard Member May 1, 2014

Owners & managing parties with NPI records 21

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 21

Facilities with the same owner 7

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751068800000",
    "number": "1104921428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 WEST OAK STREET",
            "city": "TITUSVILLE",
            "state": "PA",
            "postal_code": "16354",
            "telephone_number": "814-827-8923",
            "fax_number": "814-827-3659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 WEST OAK STREET",
            "city": "TITUSVILLE",
            "state": "PA",
            "postal_code": "16354",
            "telephone_number": "814-827-8923",
            "fax_number": "814-827-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TITUSVILLE AREA HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2025-06-28",
        "certification_date": "2025-06-28",
        "status": "A",
        "authorized_official_last_name": "NEELY",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "814-827-8923"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "PA",
            "license": "200901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Titusville Area Hospital Swing Bed",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Titusville, PA

Sources for this page

Verify at the official NPI Registry.