Individual provider Active NPI

Brian Garrett Rockower, M.D.

  • Child & Adolescent Psychiatry Physician
  • State College, PA
National Provider Identifier
1225062508
Registry record updated Jun 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
MD428760 Issued in PA
Practice address
320 Rolling Ridge Dr
Suite 100
State College, PA 16801-7641
Phone
(814) 867-0670
Fax
(814) 867-7616
NPI assigned
Jul 10, 2006
Last updated
Jun 20, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X MD428760 PA Primary

Addresses

Primary practice location

320 Rolling Ridge Dr
Suite 100
State College, PA 16801-7641

Mailing address

320 Rolling Ridge Dr
Suite 100
State College, PA 16801-7641
Phone (814) 867-0670

Other identifiers 1

IdentifierTypeStateIssuer
1017008480001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060830000004 PA Practitioner - Psychiatry 1052315314 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Behavioral Health of the Alleghenies CurrentSince Dec 15, 2010 Accepting new patients
Nulton Diagnostic & Treatment Center, PC CurrentSince Aug 16, 2017 Accepting new patients
Nulton Diagnostic & Treatment Center, PC. CurrentSince Aug 16, 2017 Accepting new patients
Cen Clear Child Services, Inc. CurrentSince Dec 2, 2011 Accepting new patients
Mount Nittany Medical Center Past Accepting new patients

Locations

500 E Chestnut Ave
Altoona, PA 16601
Phone (814) 942-1903

214 College Park Plz
Johnstown, PA 15904
Phone (814) 262-0025

500 Walnut St
McKeesport, PA 15132
Phone (412) 675-6498

50 Bigler Rd
Woodland, PA 16881

Interoperability endpoints

  • Direct secure messaging: brian.g.rockower@upmcdirect.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371686400000",
    "number": "1225062508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 ROLLING RIDGE DR",
            "address_2": "SUITE 100",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017641",
            "telephone_number": "814-867-0670",
            "fax_number": "814-867-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 ROLLING RIDGE DR",
            "address_2": "SUITE 100",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017641",
            "telephone_number": "814-867-0670",
            "fax_number": "814-867-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCKOWER",
        "first_name": "BRIAN",
        "middle_name": "GARRETT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2013-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD428760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1017008480001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.