NPIMap

Organization Active NPI

Mon-Vale Specialty Practices, Inc

  • Surgery Physician
  • MC Murray, PA
National Provider Identifier
1154736619
Registry record updated Jun 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD023828E Issued in PA
Legal business name
MON-VALE SPECIALTY PRACTICES, INC
Practice address
2001 Waterdam Plaza Dr
Suite 108
MC Murray, PA 15317-5416
Phone
(724) 942-0010
Fax
(724) 942-0040
NPI assigned
Jun 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2014

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

Authorized official

Name
Daniel Simmons
Title
Secretary/Treasurer
Phone
(724) 258-1106

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X MD023828E PA Primary

Addresses

Primary practice location

2001 Waterdam Plaza Dr
Suite 108
MC Murray, PA 15317-5416

Mailing address

1163 Country Club Rd
Attention Daniel Simmons
Monongahela, PA 15063-1013
Phone (724) 258-1106

Other names 1

  • Mon-Vale Breast Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130128000282 PA Part B Supplier - Clinic/Group Practice 0042464026 Receives reassigned benefits from 25 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Uniontown, PA; Rostraver TWP, PA; Rostraver Township, PA; Punxsutawney, PA; Monongahela, PA; McMurray, PA; Greensburg, PA; Du Bois, PA…

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Mon-Vale Specialty Practices Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1275 S Main St
Ste 205
Greensburg, PA 15601
Phone (724) 603-2108

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403568000000",
    "number": "1154736619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1163 COUNTRY CLUB RD",
            "address_2": "ATTENTION DANIEL SIMMONS",
            "city": "MONONGAHELA",
            "state": "PA",
            "postal_code": "150631013",
            "telephone_number": "724-258-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 WATERDAM PLAZA DR",
            "address_2": "SUITE 108",
            "city": "MC MURRAY",
            "state": "PA",
            "postal_code": "153175416",
            "telephone_number": "724-942-0010",
            "fax_number": "724-942-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MON-VALE SPECIALTY PRACTICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-24",
        "last_updated": "2014-06-24",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "724-258-1106"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD023828E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mon-Vale Breast Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in MC Murray, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2014; 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.