NPIMap

Individual provider Active NPI

Jeffrey W. Pro, M.D.

  • Internal Medicine Physician
  • State College, PA
National Provider Identifier
1114980208
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD058797L Issued in PA
Practice address
1850 E Park Ave
Suite 302
State College, PA 16803-6706
Phone
(814) 278-4680
Fax
(814) 235-1523
NPI assigned
Apr 10, 2006
Last updated
Nov 10, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD058797L PA Primary

Addresses

Primary practice location

1850 E Park Ave
Suite 302
State College, PA 16803-6706

Mailing address

1850 E Park Ave
Suite 302
State College, PA 16803-6706
Phone (814) 278-4680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031229000511 PA Practitioner - Internal Medicine 7214835248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Eastern Virginia Medical School, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

129 Medical Park LN
Bellefonte, PA 16823-9112
Phone (814) 355-3626

141 Medical Park LN
Bellefonte, PA 16823-9112
Phone (814) 355-7322

143 Hospital Dr
State College, PA 16803-5500
Phone (814) 237-3470

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Nittany Medical Center Health Services Inc Internal Medicine CurrentSince Jan 1, 2011 Accepting new patients
Allegheny Clinic Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Mount Nittany Medical Center Health Services Inc Past Accepting new patients
Allegheny Medical Practice Network Past Accepting new patients

Locations

141 Medical Park Ln
Bellefonte, PA 16823
Phone (814) 355-7322

143 Hospital Dr
Ste 302
State College, PA 16803
Phone (814) 278-4680

1850 E Park Ave
State College, PA 16803
Phone (814) 234-6750

1850 E Park Ave
#201
State College, PA 16803
Phone (814) 234-8800

1850 E Park Ave
Fl 2
State College, PA 16803
Phone (814) 237-3470

1850 E Park Ave
Ste 201
State College, PA 16803
Phone (814) 234-8800

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
Mount Nittany Medical CenterState College, PA, CCN 390268 Hospital Corporate Director Jan 17, 2022

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 45

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1114980208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 E PARK AVE",
            "address_2": "SUITE 302",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036706",
            "telephone_number": "814-278-4680",
            "fax_number": "814-235-1523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 E PARK AVE",
            "address_2": "SUITE 302",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036706",
            "telephone_number": "814-278-4680",
            "fax_number": "814-235-1523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRO",
        "first_name": "JEFFREY",
        "middle_name": "W.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2015-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD058797L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.