Glendale Area Medical Association, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

GLENDALE AREA MEDICAL ASSOCIATION, INC

Practice address

850 Main Street
Coalport, PA 16627-0375

Phone

(814) 672-5141

Fax

(814) 672-5461

NPI assigned

Mar 17, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Scott Vinglas

Title

Ceo

Phone

(814) 672-5141

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Glendale Area Medical Center Doing business as

Medicare fee-for-service enrollment

Enrolled in PA2 enrollments

Enrollment records 2

Federally qualified health center certification: CCN 391822

Legal name

GLENDALE AREA MEDICAL ASSOCIATION INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Oct 1, 1991

Last certification

Oct 1, 1991

Ownership / control type

Non-profit – other

Organization structure

CorporationNon-profit

Incorporated

Oct 28, 1977 in PA

Enrollment address

850 Main Street
Coalport, PA 16627

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

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CHDFBD

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Shena A Duprez, LPC

  • Professional Counselor
  • Coalport, PA
  • NPI 1225544661

  Corporate Officer

  CMS ownership

Practitioners 9

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

• Brian R Oberneder, DPM

  • Foot Surgery Podiatrist
  • Johnstown, PA
  • NPI 1578502381
  Medicare reassignment Care Compare group NPD
• Jay A Robinson, M.D.

  • Adult Medicine Physician
  • Coalport, PA
  • NPI 1811972995
  Medicare reassignment Care Compare group NPD
• Sohail Shariff, M.D.

  • Family Medicine Physician
  • Coalport, PA
  • NPI 1194730929
  Medicare reassignment Care Compare group NPD
• Staci Kephart, PA

  • Physician Assistant
  • Coalport, PA
  • NPI 1619225828
  Medicare reassignment
• Lindsey Elizabeth Link, PA-C

  • Medical Physician Assistant
  • Coalport, PA
  • NPI 1487107330
  Medicare reassignment
• Jordan Emma McClellan, PA-C

  • Physician Assistant
  • Coalport, PA
  • NPI 1851071468
  Medicare reassignment
• Anthony M Kibelbek, D.M.D.

  • Dentist
  • Coalport, PA
  • NPI 1902825219
  NPD (past)
• Rachel Elizabeth Mock, PA-C

  • Physician Assistant
  • Coalport, PA
  • NPI 1578848446
  NPD (past)
• Deborah Jo Savino, DH

  • Dental Hygienist
  • Coalport, PA
  • NPI 1255843066
  NPD (past)

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1255300596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 MAIN STREET",
            "address_2": "P.O. BOX 375",
            "city": "COALPORT",
            "state": "PA",
            "postal_code": "166270375",
            "telephone_number": "814-672-5141",
            "fax_number": "814-672-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 MAIN STREET",
            "city": "COALPORT",
            "state": "PA",
            "postal_code": "166270375",
            "telephone_number": "814-672-5141",
            "fax_number": "814-672-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDALE AREA MEDICAL ASSOCIATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-17",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "VINGLAS",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "814-672-5141",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA 1965",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "391822",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glendale Area Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Glendale Area Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cambrian Rehabilitation Associates, P.C.
• Shena A Duprez, LPC
• Mary Elizabeth Gabriel, D.P.T.
• Gregory P Gates, DMD
• Glendale Rehabilitation Inc.
• Staci Kephart, PA
• Anthony M Kibelbek, D.M.D.
• Kinetics Counseling
• Laura J Rizzo DMD PC

• Federally Qualified Health Center (FQHC) in Coalport, PA
• Providers in Coalport, PA by specialty
• Federally Qualified Health Center (FQHC) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.