NPIMap

Organization Active NPI

Meadville Medical Center

  • Pain Medicine (Anesthesiology) Physician
  • Meadville, PA
National Provider Identifier
1174067458
Registry record updated Dec 6, 2016
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
Practice address
1034 Grove St
Meadville, PA 16335-2945
Phone
(814) 333-5736
Fax
(814) 333-5819
NPI assigned
Dec 6, 2016
Organization subpart
No

Authorized official

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

Owned or controlled facilities with NPI records 8

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

Other NPIs with the same Medicare PAC ID 20

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

Practitioners 140

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

View all 140

Medicare participation

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

All facility ownership & control disclosures 8

Medicare enrollment files

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

Medicare enrollment records 1

Medicare enrollment files
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

National Provider Directory

National Provider Directory

Locations

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

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

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

NPPES NPI Registry
  • Clinic for Specialty Pain Services Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 6, 2016.

{
    "created_epoch": "1480982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480982400000",
    "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": "2016-12-06",
        "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.