NPIMap

Organization Active NPI

Erie Physicians Network-Upmc,Inc

  • Family Medicine Physician
  • Erie, PA
National Provider Identifier
1366726259
Registry record updated Apr 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ERIE PHYSICIANS NETWORK-UPMC,INC
Practice address
1325 W 26TH St
Erie, PA 16508-1469
Phone
(412) 647-0943
Fax
(412) 647-4050
NPI assigned
Oct 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2012

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

Authorized official

Name
Mr. Mark Ehalt
Title
Sr.Director
Phone
(412) 647-0943

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X
Sleep Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0012X
Orthopaedic Foot and Ankle Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0004X
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X

Addresses

Primary practice location

1325 W 26TH St
Erie, PA 16508-1469

Mailing address

2861 W 26TH St
Suite 2
Erie, PA 16506-3064
Phone (814) 835-3751

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120110000034 PA Part B Supplier - Clinic/Group Practice 1052587268 Receives reassigned benefits from 31 practitioners
Practice locations: Erie, PA

National Provider Directory

National Provider Directory

Locations

336 York St
Corry, PA 16407
Phone (814) 664-4641

1101 Peninsula Dr
Ste 202203
Erie, PA 16505

104 E 2nd St
Erie, PA 16507
Phone (814) 455-4404

1101 Peninsula Dr
Ste 202
Erie, PA 16505
Phone (814) 833-5381

2059 W 8th St
Erie, PA 16505
Phone (814) 459-6667

104 E 2nd St
Fl 3
Erie, PA 16507
Phone (814) 456-2229

2861 W 26th St
Ste 2
Erie, PA 16506
Phone (814) 835-3751

4108 Zuck Rd
Ste D
Erie, PA 16506

3910 Caughey Rd
Ste 170
Erie, PA 16506
Phone (814) 838-3480

333 State St
Ste 206
Erie, PA 16507
Phone (814) 459-1013

3535 Pine Ave
Erie, PA 16504
Phone (814) 454-3363

Practitioners & affiliated clinicians

Practitioners 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333929600000",
    "number": "1366726259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2861 W 26TH ST",
            "address_2": "SUITE 2",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165063064",
            "telephone_number": "814-835-3751",
            "fax_number": "814-835-3755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 W 26TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081469",
            "telephone_number": "412-647-0943",
            "fax_number": "412-647-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIE PHYSICIANS NETWORK-UPMC,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-11",
        "last_updated": "2012-04-09",
        "status": "A",
        "authorized_official_last_name": "EHALT",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "SR.DIRECTOR",
        "authorized_official_telephone_number": "412-647-0943",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; 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.