NPIMap

Organization Active NPI

Mon-Vale Specialty Practices, Inc

  • Gynecology Physician
  • Monongahela, PA
National Provider Identifier
1356695720
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
MON-VALE SPECIALTY PRACTICES, INC
Practice address
1163 Country Club Rd
Suite 101
Monongahela, PA 15063-1013
Phone
(724) 258-2229
NPI assigned
Nov 6, 2012
Last updated
Jul 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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

Authorized official

Name
Daniel Simmon
Title
Secretary/Treasurer
Phone
(724) 258-1106

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU
Gynecology Physician 207VG0400X NU Primary
Obstetrics Physician 207VX0000X NU

Addresses

Primary practice location

1163 Country Club Rd
Suite 101
Monongahela, PA 15063-1013

Mailing address

1163 Country Club Rd
Monongahela, PA 15063-1013
Phone (724) 258-1106

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130128000282 PA Part B Supplier - Clinic/Group Practice 0042464026 Receives reassigned benefits from 25 practitioners
7 other NPIs on this enrollment
Practice locations: Uniontown, PA; Rostraver TWP, PA; Rostraver Township, PA; Punxsutawney, PA; Monongahela, PA; McMurray, PA; Greensburg, PA; Du Bois, PA…

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Mon-Vale Specialty Practices Inc4 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.

Locations

700 Park St
Connellsville, PA 15425
Phone (724) 603-2652

800 Plaza Dr
Ste 160
Rostraver Township, PA 15012
Phone (724) 797-9550

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595548800000",
    "number": "1356695720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1163 COUNTRY CLUB RD",
            "city": "MONONGAHELA",
            "state": "PA",
            "postal_code": "150631013",
            "telephone_number": "724-258-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1163 COUNTRY CLUB RD",
            "address_2": "SUITE 101",
            "city": "MONONGAHELA",
            "state": "PA",
            "postal_code": "150631013",
            "telephone_number": "724-258-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MON-VALE SPECIALTY PRACTICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-06",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A",
        "authorized_official_last_name": "SIMMON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "724-258-1106"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monongahela, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.