Pediatric Care Specialists

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS016634 Issued in PA

Legal business name

PEDIATRIC CARE SPECIALISTS

Practice address

1322 Eisenhower Blvd
Pediatric Care Specialists
Johnstown, PA 15904

Phone

(814) 266-8840

Fax

(814) 266-2176

NPI assigned

May 4, 2011

Organization subpart

Yes

Parent organization

PEDIATRIC CARE SPECIALISTSAs reported in NPPES

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

Authorized official

Name

Ms. Patricia Lynn Avramis

Title

Privacy Officer

Phone

(814) 266-8840

Specialties & licenses 2

Addresses

Other identifiers 1

Tax ID family

Pediatric Care Specialists2 organizations share this tax ID, including this one

Part of

Pediatric Care Specialists

Other organizations with this tax ID 1

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

• Pediatric Care Specialists

  • Multi-Specialty Clinic/Center
  • Johnstown, PA
  • NPI 1346236833
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Pediatric Care Specialists

  • Multi-Specialty Clinic/Center
  • Johnstown, PA
  • NPI 1346236833
  NPPES parent name

Practitioners 2

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

• Venkata R Dharbhamulla, MD

  • Pediatrics Physician
  • Johnstown, PA
  • NPI 1033272513
  NPD
• Andrew A. Garbarino, MD

  • Pediatrics Physician
  • Johnstown, PA
  • NPI 1366503013
  NPD

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304467200000",
    "number": "1124310586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 EISENHOWER BLVD",
            "address_2": "PEDIATRIC CARE SPECIALISTS",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "15904",
            "telephone_number": "814-266-8840",
            "fax_number": "814-266-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 EISENHOWER BLVD",
            "address_2": "PEDIATRIC CARE SPECIALISTS",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "15904",
            "telephone_number": "814-266-8840",
            "fax_number": "814-266-2176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CARE SPECIALISTS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEDIATRIC CARE SPECIALISTS",
        "enumeration_date": "2011-05-04",
        "last_updated": "2011-05-04",
        "status": "A",
        "authorized_official_last_name": "AVRAMIS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRIVACY OFFICER",
        "authorized_official_telephone_number": "814-266-8840",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS016634",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "PA",
            "license": "CW015802",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007708200003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Lynn Pcola
• Samantha J Pcola, PA-C
• Peaceful Heart Counseling
• Josephine Pearson
• Scott Edward Pearson, CRNA
• Pediatric Care Specialists
• Peerstar, LLC
• Peerstar,LLC
• Adriana Dietz Pellegrini, DO
• Brandi L Penatzer, PA

• Psychologist in Johnstown, PA
• Providers in Johnstown, PA by specialty
• Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.