NPIMap

Organization Active NPI

Broad Top Area Medical Center Inc

Doing business as BTAMC Inc SHCMC Dental Clinic

  • Federally Qualified Health Center (FQHC)
  • Orbisonia, PA
National Provider Identifier
1154055853
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BROAD TOP AREA MEDICAL CENTER INC
Doing business as
BTAMC Inc SHCMC Dental Clinic
BTAMC SHCMC Dental Clinic
Practice address
626 Water St Ste 2
Orbisonia, PA 17243-9432
Phone
(814) 447-3159
NPI assigned
Jul 11, 2022
Last updated
Aug 28, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
BROAD TOP AREA MEDICAL CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Authorized official

Name
Shani Reed
Title
Director, Enrollment
Phone
(814) 506-8463

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

626 Water St Ste 2
Orbisonia, PA 17243-9432

Mailing address

4133 Medical Center Dr
Broad Top, PA 16621-9001
Phone (814) 635-2916

Other names 2

  • BTAMC Inc SHCMC Dental Clinic Doing business as
  • BTAMC SHCMC Dental Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050420000158 PA Part B Supplier - Clinic/Group Practice 2860430972 Receives reassigned benefits from 35 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Orbisonia, PA; Mount Union, PA; Broad Top, PA; Huntingdon, PA; Cassville, PA; Belleville, PA; Alexandria, PA
O20220830003539 PA Part A Provider - Federally Qualified Health Center (FQHC) 2860430972 Practice locations: Orbisonia, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154055853. Details of each certification follow.

Federally qualified health center certification: CCN 731001

Legal name
BROAD TOP AREA MEDICAL CENTER INC
Doing business as
BTAMC INC SHCMC DENTAL CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 23, 2022
Last certification
Aug 23, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
626 Water St
Ste 2
Orbisonia, PA 17243-9432

Other NPIs with the same Medicare PAC ID 11

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

Other NPIs on the same Medicare enrollment 11

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

National Provider Directory

National Provider Directory
Tax ID family
Brroad Top Area Medical10 organizations share this tax ID, including this one
Part of
Brroad Top Area Medical

Other organizations with this tax ID 9

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

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Donna McCabe Individual Corporate DirectorBoard Member Aug 1, 2016
Shani Reed Individual Corporate DirectorEnrollment Director Jan 1, 2019
Operational/Managerial ControlEnrollment Director Jan 1, 2019
Malvin Deluca Individual Corporate DirectorBoard President Jun 22, 2017
Wendy Melius Individual Corporate DirectorBoard Vice President Jun 1, 2016
John D. Roth Individual Corporate OfficerChief Executive Officer (Ceo) Dec 1, 2018
Matthew Stoudnour Individual Corporate DirectorBoard Member Mar 28, 2019
Paul Wright Individual Corporate DirectorBoard Member Oct 1, 2019
Bertha Peffer Individual Corporate DirectorBoard Treasurer Jun 22, 2017
Wayne N Fisher Individual Corporate DirectorBoard Member Jun 22, 2017
Cheryl Marino Individual Corporate DirectorBoard Member Jan 27, 2022
Jason Horton Individual Corporate DirectorBoard Member Mar 28, 2019
Barbara Lucas Individual Corporate DirectorBoard Secretary Aug 1, 2016
Joie Escuadro Individual Corporate DirectorBoard Member Jan 27, 2022
Christopher Crawshaw Individual Corporate OfficerChief Financial Officer (Cfo) Feb 1, 2019
James B Hayden Individual Corporate OfficerChief Medical Officer (Cmo) Dec 1, 2018

Owners & managing parties with NPI records 1

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787875200000",
    "number": "1154055853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4133 MEDICAL CENTER DR",
            "city": "BROAD TOP",
            "state": "PA",
            "postal_code": "166219001",
            "telephone_number": "814-635-2916",
            "fax_number": "814-635-2918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 WATER ST STE 2",
            "city": "ORBISONIA",
            "state": "PA",
            "postal_code": "172439432",
            "telephone_number": "814-447-3159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROAD TOP AREA MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROAD TOP AREA MEDICAL CENTER, INC",
        "enumeration_date": "2022-07-11",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "SHANI",
        "authorized_official_title_or_position": "DIRECTOR, ENROLLMENT",
        "authorized_official_telephone_number": "814-506-8463"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BTAMC Inc SHCMC Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BTAMC SHCMC Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orbisonia, PA

Sources for this page

Verify at the official NPI Registry.