Organization Active NPI

Philip a Gelacek MD PC

  • Geriatric Medicine (Family Medicine) Physician
  • Ford City, PA
National Provider Identifier
1205986296
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
MD020788E Issued in PA
Legal business name
PHILIP A GELACEK MD PC
Practice address
904 4TH Ave
Ford City, PA 16226-1212
Phone
(724) 763-7144
Fax
(724) 763-7161
NPI assigned
Jan 11, 2007
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
Philip A Gelacek, MDNPI 1871588087
Title
President
Phone
(724) 763-7144

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X MD020788E PA Primary

Addresses

Primary practice location

904 4TH Ave
Ford City, PA 16226-1212

Mailing address

904 4TH Ave
Ford City, PA 16226-1212
Phone (724) 763-7144

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060420000059 PA Part B Supplier - Clinic/Group Practice 1850300757 Receives reassigned benefits from 6 practitioners
Practice locations: Ford City, PA

National Provider Directory

National Provider Directory

Locations

904 Fourth Ave
Ford City, PA 16226
Phone 72476371443

904 4TH Ave
Ford City, PA 16226
Phone (724) 763-7144

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": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205986296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 4TH AVE",
            "city": "FORD CITY",
            "state": "PA",
            "postal_code": "162261212",
            "telephone_number": "724-763-7144",
            "fax_number": "724-763-7161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 4TH AVE",
            "city": "FORD CITY",
            "state": "PA",
            "postal_code": "162261212",
            "telephone_number": "724-763-7144",
            "fax_number": "724-763-7161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP A GELACEK MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GELACEK",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "724-763-7144",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "PA",
            "license": "MD020788E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ford City, 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.