NPIMap

Organization Active NPI

Centre Medical and Surgical Associates, P.C.

  • Internal Medicine Physician
  • State College, PA
National Provider Identifier
1306803531
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD017746E Issued in PA
Legal business name
CENTRE MEDICAL AND SURGICAL ASSOCIATES, P.C.
Practice address
1850 E Park Ave
Suite 201
State College, PA 16803-6706
Phone
(814) 234-8800
Fax
(814) 234-8068
NPI assigned
May 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
John McQueary
Title
Coo/Administrative Director
Phone
(814) 234-4753

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X MD017746E PA Primary

Addresses

Primary practice location

1850 E Park Ave
Suite 201
State College, PA 16803-6706

Mailing address

1850 E Park Ave
Suite 201
State College, PA 16803-6706
Phone (814) 234-8800

Other identifiers 2

IdentifierTypeStateIssuer
50047343OtherPACAPITAL BLUE CROSS
1007679310027MedicaidPA

Other names 1

  • Specialists Other name

National Provider Directory

National Provider Directory
Tax ID family
Centre Medical and Surgical Associates PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306803531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 E PARK AVE",
            "address_2": "SUITE 201",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036706",
            "telephone_number": "814-234-8800",
            "fax_number": "814-234-8068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 E PARK AVE",
            "address_2": "SUITE 201",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036706",
            "telephone_number": "814-234-8800",
            "fax_number": "814-234-8068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRE MEDICAL AND SURGICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCQUEARY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "COO/ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "814-234-4753"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD017746E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50047343",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007679310027",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Specialists",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.