NPIMap

Organization Active NPI

DLP Conemaugh Physician Practices LLC

  • Family Medicine Physician
  • Ebensburg, PA
National Provider Identifier
1124434162
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DLP CONEMAUGH PHYSICIAN PRACTICES LLC
Practice address
171 Lovell Ave
Lovell Park Professional Building
Ebensburg, PA 15931-1855
Phone
(814) 472-4090
NPI assigned
Jul 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Authorized official

Name
Monica Bowman
Title
President
Phone
(615) 920-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

171 Lovell Ave
Lovell Park Professional Building
Ebensburg, PA 15931-1855

Mailing address

171 Lovell Ave
Lovell Park Professional Building
Ebensburg, PA 15931-1855
Phone (814) 472-4090

Other names 1

  • CHI MASTRINE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140915002522 PA Part B Supplier - Clinic/Group Practice 7315166949 Receives reassigned benefits from 836 practitioners
28 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Conemaugh Health Initiatives25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

Locations

171 Lovell Ave
Ebensburg, PA 15931
Phone (814) 472-4090

Ownership & related parties

Other NPIs on the same Medicare enrollment 28

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 28

Practitioners 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675728000000",
    "number": "1124434162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 LOVELL AVE",
            "address_2": "LOVELL PARK PROFESSIONAL BUILDING",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159311855",
            "telephone_number": "814-472-4090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 LOVELL AVE",
            "address_2": "LOVELL PARK PROFESSIONAL BUILDING",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159311855",
            "telephone_number": "814-472-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DLP CONEMAUGH PHYSICIAN PRACTICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-10",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHI MASTRINE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHI MASTRINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ebensburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.