NPIMap

Individual provider Active NPI

Michael A Lettieri, M.D.

  • Family Medicine Physician
  • Huntingdon, PA
National Provider Identifier
1285652446
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD054433L Issued in PA
Practice address
6674 Towne Center Blvd
Huntingdon, PA 16652-6934
Phone
(814) 643-1232
Fax
(814) 643-4267
NPI assigned
Jul 17, 2006
Last updated
Jun 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD054433L PA Primary

Addresses

Primary practice location

6674 Towne Center Blvd
Huntingdon, PA 16652-6934

Mailing address

4133 Medical Center Dr
Broad Top, PA 16621-9001
Phone (814) 635-2916

Other identifiers 1

IdentifierTypeStateIssuer
001512907-0017MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040213000242 PA Practitioner - Family PracticePractitioner - Emergency Medicine 4284528704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6678 Towne Ctr Blvd
Huntingdon, PA 16652-6934
Phone (814) 643-1232

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD054433LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Broad Top Area Medical Center Inc Current Accepting new patients
Broad Top Area Medical Center Inc CurrentSince Feb 26, 2022 Accepting new patients
Charles Cole Memorial Hospital D/B/a Upmc Cole Past Accepting new patients
Charles Cole Memorial D/B/a Upmc Cole Past Accepting new patients
Miners Hospital Emergency Medicine Past Accepting new patients
Miners Hospital Emergency Medicine Past Accepting new patients
Medexpress Urgent Care, PC - Monaca Emergency Medicine Past Accepting new patients

Locations

375 S Kishacoquillas St
Belleville, PA 17004
Phone (717) 935-2065

4133 Medical Center Dr
Broad Top, PA 16621
Phone (814) 506-8463

6678 Towne Center Blvd
Huntingdon, PA 16652
Phone (814) 506-8490

Interoperability endpoints

  • Direct secure messaging: m.lettieri@broadtopmedical.medentdirect.com

Organizations & group practices 7

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1285652446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4133 MEDICAL CENTER DR",
            "city": "BROAD TOP",
            "state": "PA",
            "postal_code": "166219001",
            "telephone_number": "814-635-2916",
            "fax_number": "814-635-2918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6674 TOWNE CENTER BLVD",
            "city": "HUNTINGDON",
            "state": "PA",
            "postal_code": "166526934",
            "telephone_number": "814-643-1232",
            "fax_number": "814-643-4267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETTIERI",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD054433L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001512907-0017",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntingdon, PA

Sources for this page

Verify at the official NPI Registry.