NPIMap

Organization Active NPI

Northeastern Rehabilitation Associates, PC

  • Ambulatory Surgical Clinic/Center
  • Moosic, PA
National Provider Identifier
1225837875
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
NORTHEASTERN REHABILITATION ASSOCIATES, PC
Practice address
20 Montage Mountain Road
Suite 1
Moosic, PA 18507
Phone
(570) 344-3789
NPI assigned
Mar 7, 2025
Organization subpart
Yes
Parent organization
NORTHEASTERN REHABILITATION ASSOCIATES, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Authorized official

Name
Renee Murphy, RN
Title
Administrator
Phone
(570) 344-3788

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

20 Montage Mountain Road
Suite 1
Moosic, PA 18507

Mailing address

20 Montage Mountain Road
Suite 1
Moosic, PA 18507

Other names 1

  • NERA Pain Center at Montage Mountain Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250521003401 PA Part B Supplier - Ambulatory Surgical Center 5193714723 Practice locations: Moosic, PA

Other NPIs with the same Medicare PAC ID 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2332298Nera Pain Center at Montage20 Montage Moutain Rd, Ste 1, Moosic, PA 18507Certificate of waiverOct 16, 2027

National Provider Directory

National Provider Directory
Part of
Northeastern Rehab Asso

Locations

20 Montage Mountain Rd
Ste 1
Moosic, PA 18507
Phone (570) 344-3788

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1741305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741305600000",
    "number": "1225837875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MONTAGE MOUNTAIN ROAD",
            "address_2": "SUITE 1",
            "city": "MOOSIC",
            "state": "PA",
            "postal_code": "18507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MONTAGE MOUNTAIN ROAD",
            "address_2": "SUITE 1",
            "city": "MOOSIC",
            "state": "PA",
            "postal_code": "18507",
            "telephone_number": "570-344-3789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEASTERN REHABILITATION ASSOCIATES, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHEASTERN REHABILITATION ASSOCIATES, PC",
        "enumeration_date": "2025-03-07",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-06",
        "status": "A",
        "authorized_official_last_name": "MURPHY",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "570-344-3788",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NERA Pain Center at Montage Mountain",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moosic, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.