NPIMap

Organization Active NPI

Elk Regional Professional Group, Inc

  • Surgery Physician
  • Saint Marys, PA
National Provider Identifier
1184611303
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
ELK REGIONAL PROFESSIONAL GROUP, INC
Practice address
763 Johnsonburg Rd
Saint Marys, PA 15857-3417
Phone
(814) 788-8580
Fax
(814) 788-8042
NPI assigned
Oct 3, 2005
Last updated
Aug 22, 2020By the provider in NPPES
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
Rita V Olszewski
Title
Vice President, Erpg
Phone
(814) 788-8580

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Primary

Addresses

Primary practice location

763 Johnsonburg Rd
Saint Marys, PA 15857-3417

Mailing address

763 Johnsonburg Rd
St Marys, PA 15857-3417
Phone (814) 788-8580

Other identifiers 1

IdentifierTypeStateIssuer
0018592850018MedicaidPA

Other names 1

  • ERPG Surgical Services Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040423000700 PA Part B Supplier - Clinic/Group Practice 4486553278 Receives reassigned benefits from 12 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kane, PA

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Elk Regional Professional Group Inc35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184611303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 JOHNSONBURG RD",
            "city": "ST MARYS",
            "state": "PA",
            "postal_code": "158573417",
            "telephone_number": "814-788-8580",
            "fax_number": "814-788-8042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 JOHNSONBURG RD",
            "city": "SAINT MARYS",
            "state": "PA",
            "postal_code": "158573417",
            "telephone_number": "814-788-8580",
            "fax_number": "814-788-8042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELK REGIONAL PROFESSIONAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OLSZEWSKI",
        "authorized_official_first_name": "RITA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "VICE PRESIDENT, ERPG",
        "authorized_official_telephone_number": "814-788-8580"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018592850018",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ERPG Surgical Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Marys, 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.
  • 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.