Broad Top Area Medical Center Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Orbisonia, PA
NPI 1154055853 · NPPES record last updated Aug 28, 2026
Key facts
- NPI
- 1154055853
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- BROAD TOP AREA MEDICAL CENTER INC
- Practice address
- 626 Water St Ste 2
Orbisonia, PA 17243-9432 - Phone
- (814) 447-3159
- NPI assigned
- Jul 11, 2022
- Organization subpart
- Yes
- Parent organization (as reported)
- BROAD TOP AREA MEDICAL CENTER, INC
Authorized official
- Name
- Shani Reed
- Title
- Director, Enrollment
- Phone
- (814) 506-8463
Parent organization (reported in NPPES) 1
Owners & managing parties with NPI records 1
-
John D Roth, M.D.
Other NPIs on the same Medicare enrollment 11
Other NPIs with the same Medicare PAC ID 11
Corporate family (same tax ID) 8
Practitioners 28
-
Bert J Altmanshofer, DPM
-
Kelly Christine Busche, PA-C
-
Carrie Claycomb, PA-C
-
Fawzia Haque, MD
-
Jennifer Holt, D.O.
-
Robert C. Lamey, M.D.
-
Michael A Lettieri, M.D.
-
Tracy A Lillie, M.D.
-
Ronald A Long, M.D.
-
Sharon Eunice Martin, MD PHD
-
Kylie McNerlin, PA-C
-
Debra Booher Messner, CRNP
-
Dawn M Mills, PAC
-
John D Roth, M.D.
-
Hope Saylor, CRNP
-
Russell A Sharpless, PA-C
-
Gregor Stanley Thebaud, D.O.
-
Bruce L Thomas, M.D.
-
Michelle Volpe, CRNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in PA
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
- Corporation · Non-profit
- Enrollment address
- 626 Water St
Ste 2
Orbisonia, PA 17243-9432
All disclosed owners & managing parties 15
| Name | Role | Since | Share |
|---|---|---|---|
| Donna McCabe |
Corporate Director |
Aug 1, 2016 | |
| Shani Reed |
Corporate Director |
Jan 1, 2019 | |
| Operational/Managerial Control |
Jan 1, 2019 | ||
| Malvin Deluca |
Corporate Director |
Jun 22, 2017 | |
| Wendy Melius |
Corporate Director |
Jun 1, 2016 | |
| John D. Roth |
Corporate Officer |
Dec 1, 2018 | |
| Matthew Stoudnour |
Corporate Director |
Mar 28, 2019 | |
| Paul Wright |
Corporate Director |
Oct 1, 2019 | |
| Bertha Peffer |
Corporate Director |
Jun 22, 2017 | |
| Wayne N Fisher |
Corporate Director |
Jun 22, 2017 | |
| Cheryl Marino |
Corporate Director |
Jan 27, 2022 | |
| Jason Horton |
Corporate Director |
Mar 28, 2019 | |
| Barbara Lucas |
Corporate Director |
Aug 1, 2016 | |
| Joie Escuadro |
Corporate Director |
Jan 27, 2022 | |
| Christopher Crawshaw |
Corporate Officer |
Feb 1, 2019 | |
| James B Hayden |
Corporate Officer |
Dec 1, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Broad Top Med Center
- Part of
- Broad Top Med Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
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
- BTAMC Inc SHCMC Dental Clinic
- BTAMC SHCMC Dental Clinic
Other providers in Orbisonia, PA
- Justin Becker
- Daniel T Bender
- Broad Top Area Medical Center Inc
- Brandy Colleen Buckley
- Carrie Claycomb
- Seth R Davis
- Embassy Woodland Park, LLC
All providers in Orbisonia, PA · Federally Qualified Health Center (FQHC) in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.