NPIMap

Organization Active NPI

Centre Medical and Surgical Associates, P.C.

  • Radiology Clinic/Center
  • State College, PA
National Provider Identifier
1174587513
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
SF ID 380309 Issued in PA
Legal business name
CENTRE MEDICAL AND SURGICAL ASSOCIATES, P.C.
Practice address
1850 E Park Ave
Suite 203
State College, PA 16803-6706
Phone
(814) 234-7200
Fax
(814) 234-8068
NPI assigned
Apr 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
John J. McQueary
Title
Coo/Administrative Director
Phone
(814) 234-4753

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X SF ID 380309 PA Primary

Addresses

Primary practice location

1850 E Park Ave
Suite 203
State College, PA 16803-6706

Mailing address

1850 E Park Ave
Suite 203
State College, PA 16803-6706
Phone (814) 234-7200

Other identifiers 2

IdentifierTypeStateIssuer
0007236940012MedicaidPA
414613OtherPAHIGHMARK BLUE SHIELD

Other names 1

  • CMSA Radiology Other name

National Provider Directory

National Provider Directory
Tax ID family
Centre Medical and Surgical Associates PC4 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

141 Medical Park Ln
Bellefonte, PA 16823
Phone (814) 355-7322

3901 S Atherton St
Ste 5
State College, PA 16801
Phone (814) 466-7921

3901 S Atherton St
Ste 2
State College, PA 16801
Phone (814) 278-4631

Practitioners & affiliated clinicians

Practitioners 1

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": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174587513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 E PARK AVE",
            "address_2": "SUITE 203",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036706",
            "telephone_number": "814-234-7200",
            "fax_number": "814-234-8068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 E PARK AVE",
            "address_2": "SUITE 203",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036706",
            "telephone_number": "814-234-7200",
            "fax_number": "814-234-8068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRE MEDICAL AND SURGICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCQUEARY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "COO/ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "814-234-4753"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "PA",
            "license": "SF ID 380309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007236940012",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "414613",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CMSA Radiology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.