NPIMap

Individual provider Active NPI

Marty Cole, MD

  • Family Medicine Physician
  • Connellsville, PA
National Provider Identifier
1295846681
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD066646L Issued in PA
Practice address
208 S. Arch Street
Connellsville, PA 15425-3519
Phone
(724) 626-2630
Fax
(724) 626-2655
NPI assigned
Aug 31, 2006
Last updated
Feb 14, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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 MD066646L PA Primary

Addresses

Primary practice location

208 S. Arch Street
Connellsville, PA 15425-3519

Mailing address

1070 National Pike Road
Fredericktown, PA 15333-2114
Phone (724) 632-6801

Other identifiers 1

IdentifierTypeStateIssuer
100877218MedicaidPA

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
I20031208000469 PA Practitioner - Family Practice 8224934765 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centerville Clinics, Inc. Current Accepting new patients
Centerville Clinics, Inc CurrentSince Jan 16, 2017 Accepting new patients
Centerville Clinics, Inc. Family Medicine CurrentSince Jan 16, 2017 Accepting new patients
Centerville Clinics, Inc. Current Accepting new patients
Centerville Clinics, Inc. Current Accepting new patients
Centerville Clinics, Inc. Current Accepting new patients
New Castle Infectious Diseases LLC Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Jer Medical Associates Past Accepting new patients
Family Practice Associates of Western PA, PC Family Medicine Past Accepting new patients
Medexpress Urgent Care, PC - Monaca Past Accepting new patients

Locations

208 S Arch St
Connellsville, PA 15425
Phone (724) 626-2630

1070 Old National Pike
Fredericktown, PA 15333

Organizations & group practices 12

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1295846681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 NATIONAL PIKE ROAD",
            "city": "FREDERICKTOWN",
            "state": "PA",
            "postal_code": "153332114",
            "telephone_number": "724-632-6801",
            "fax_number": "724-632-6312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 S. ARCH STREET",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154253519",
            "telephone_number": "724-626-2630",
            "fax_number": "724-626-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "MARTY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD066646L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100877218",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Connellsville, PA

Sources for this page

Verify at the official NPI Registry.