NPIMap

Organization Active NPI

Meadville Medical Center

Doing business as Clinic for Specialty Pain Services

  • Pain Medicine (Anesthesiology) Physician
  • Meadville, PA
National Provider Identifier
1174067458
Registry record updated Oct 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
MD421359 Issued in PA
Legal business name
MEADVILLE MEDICAL CENTER
Doing business as
Clinic for Specialty Pain Services
Practice address
1034 Grove St
Meadville, PA 16335-2945
Phone
(814) 333-5736
Fax
(814) 333-5819
NPI assigned
Dec 6, 2016
Reactivated
Oct 19, 2026
Last updated
Oct 19, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2026

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

Authorized official

Name
Mr. Renato J Suntay
Title
Cfo
Phone
(814) 333-5031

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X MD421359 PA Primary

Addresses

Primary practice location

1034 Grove St
Meadville, PA 16335-2945

Mailing address

1034 Grove St
Meadville, PA 16335-2945
Phone (814) 333-5736

Other names 1

  • Clinic for Specialty Pain Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170428001463 PA Part B Supplier - Clinic/Group Practice 4284535790 Receives reassigned benefits from 4 practitioners
Practice locations: Meadville, PA; Erie, PA

Other NPIs with the same Medicare PAC ID 20

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

View all 20

National Provider Directory

National Provider Directory

Locations

1034 Grove St
Spc Pain
Meadville, PA 16335
Phone (814) 333-5736

Ownership & related parties

All facility ownership & control disclosures 8

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

FacilityTypeRoleSince
Meadville Medical CenterMeadville, PA, CCN 390113 Hospital Operational/Managerial Control Sep 15, 2008
Titusville Area HospitalTitusville, PA, CCN 391314 Hospital 5% Or Greater Indirect Ownership Interest Oct 1, 2015
Titusville Area HospitalTitusville, PA, CCN 39Z314 Hospital 5% Or Greater Indirect Ownership Interest Oct 1, 2015
Vna AllianceMeadville, PA, CCN 397655 Home health agency 5% Or Greater Direct Ownership Interest (25%) Jun 28, 2023
Titusville Area HospitalTitusville, PA, CCN 393438 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Oct 1, 2015
Titusville Area HospitalTitusville, PA, CCN 393442 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Oct 1, 2015
Titusville Area HospitalOil City, PA, CCN 393441 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Oct 1, 2015
Tionesta Health CenterTionesta, PA, CCN 393449 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Oct 1, 2015

Owned or controlled facilities with NPI records 8

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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1480982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792368000000",
    "number": "1174067458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 GROVE ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352945",
            "telephone_number": "814-333-5736",
            "fax_number": "814-333-5819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 GROVE ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352945",
            "telephone_number": "814-333-5736",
            "fax_number": "814-333-5819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADVILLE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-06",
        "last_updated": "2026-10-19",
        "deactivation_date": "2026-09-25",
        "reactivation_date": "2026-10-19",
        "status": "A",
        "authorized_official_last_name": "SUNTAY",
        "authorized_official_first_name": "RENATO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "814-333-5031",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "PA",
            "license": "MD421359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinic for Specialty Pain Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Meadville, PA

Sources for this page

Verify at the official NPI Registry.