NPIMap

Tyrone Hospital

Organization Active NPI Rural Health Clinic/Center · Houtzdale, PA

NPI 1124456157 · NPPES record last updated Mar 23, 2026

Key facts

NPI
1124456157
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
TYRONE HOSPITAL
Practice address
120 Spring St
Houtzdale, PA 16651-1400
Phone
(814) 497-4297
Fax
(814) 497-4312
NPI assigned
Oct 30, 2013
Organization subpart
Yes
Parent organization (as reported)
PENN HIGHLANDS HEALTHCARE

Authorized official

Name
Brian S Kline
Title
VP Financial Affairs
Phone
(814) 375-6377

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.

Owners & managing parties with NPI records 7

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

Owned or controlled facilities with NPI records 2

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

Other NPIs on the same Medicare enrollment 2

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

Other NPIs with the same Medicare PAC ID 3

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

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

Facilities with the same owner 16

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

Practitioners 23

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

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2077312Tyrone Hospital Houtzdale Center
120 Spring St, Houtzdale, PA 16651		Certificate of waiverMay 5, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in PA

Rural health clinic certification: CCN 393427

Legal name
TYRONE HOSPITAL
Doing business as
PENN HIGHLANDS TYRONE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 27, 2014
Last certification
Jul 29, 2020
Ownership / control type
2B
Organization structure
Corporation · Non-profit
Incorporated
May 1, 2013 in PA
Enrollment address
120 Spring Street
Tyrone Hospital Rural Health Clinic
Houtzdale, PA 16651-1400
Related CCNs
391307

All disclosed owners & managing parties 23

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

NameRoleSinceShare
Jourdan D Strishock
Individual 		W-2 Managing Employee
Compliance Supervisor		 Aug 1, 2021
Robert a Ordiway
Individual 		Corporate Director Jul 1, 2019
Thomas a Carnevale
Individual 		Corporate Director Jul 1, 2021
Heather Schneider
Individual 		Corporate Director
Cfo		 May 10, 2022
W-2 Managing Employee May 10, 2022
Fred Price
Individual 		Corporate Director Jul 1, 2022
Hazem F Elkassas
Individual 		Corporate Director Jul 1, 2020
Penn Highlands Healthcare, Inc.
Organization · Du Bois, PA
Non-profit 		Operational/Managerial Control Nov 1, 2020
Robert W O'Leary
Individual 		Corporate Director Jul 1, 2021
Tyrone Hospital
Organization · Tyrone, PA
Non-profit 		5% Or Greater Direct Ownership Interest Nov 1, 2013 100%
Joanne Ryan
Individual 		Corporate Officer Jul 1, 2022
David Lezzer
Individual 		Corporate Director Jul 1, 2021
James E Devlin
Individual 		Corporate Director Jul 1, 2022
Lawrence Kiefer
Individual 		Corporate Director Jul 1, 2022
Todd P Stoltz
Individual 		Corporate Director Jul 1, 2022
Carlyn Belczyk
Individual 		Corporate Director Oct 1, 2021
Samuel Lewis
Individual 		Corporate Director Feb 1, 2021
Bradley Bassi
Individual 		Corporate Director Oct 1, 2021
Richard L Pfingstler
Individual 		Corporate Director Jul 1, 2021
Donald E Conrad
Individual 		Corporate Director Jul 1, 2021
Scott H Foradora
Individual 		Corporate Director Jul 1, 2020
William H Young
Individual 		Corporate Director Jul 1, 2021
Mark McGinley
Individual 		Corporate Director Oct 1, 2021
James B Ryan
Individual 		Corporate Director Jul 1, 2020

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Penn Highlands Tyrone Rural Health Clinic
Tyrone, PA · CCN 393425		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 15, 2013

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20140204001682 PA Part a Provider - Rural Health Clinic 4183619885 Practice locations: Houtzdale, PA
O20140905000044 PA Part B Supplier - Clinic/Group Practice 4183619885 Receives reassigned benefits from 14 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Houtzdale, PA; Tyrone, PA

National Provider Directory

Part of
Doppler Department Tyro

Locations

125 Spring St
Houtzdale, PA 16651
Phone (814) 497-4297

120 Spring St
Houtzdale, PA 16651
Phone (814) 497-4297

221 Hospital Dr
Ste 6
Tyrone, PA 16686
Phone (814) 684-3101

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Yes

Addresses

Primary practice location

120 Spring St
Houtzdale, PA 16651-1400

Mailing address

187 Hospital Dr
Tyrone, PA 16686-1808
Phone (814) 375-4200

Other identifiers

IdentifierTypeStateIssuer
100773400-0026MedicaidPA
393427OtherPAPTAN

Other names

  • Penn Highlands Tyrone Doing business as
  • Tyrone Hospital Rural Health Clinic Houtzdale Doing business as
  • Penn Highlands Tyrone Rural Health Clinic - Houtzdale Other name

Other providers in Houtzdale, PA

All providers in Houtzdale, PA · Rural Health Clinic/Center in Pennsylvania

Sources for this page

Verify at the official NPI Registry.