NPIMap

Organization Active NPI

Allegheny Clinic

Doing business as Ahn Ellwood Primary Care

  • Family Medicine Physician
  • Ellwood City, PA
National Provider Identifier
1376076760
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ALLEGHENY CLINIC
Doing business as
Ahn Ellwood Primary Care
Practice address
1673 Route 65
Ellwood City, PA 16117-5217
Phone
(724) 758-7559
Fax
(724) 758-7560
NPI assigned
Apr 4, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Authorized official

Name
Cindy Waltemire
Title
Provider Credentialing Specialist
Phone
(724) 272-9068

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1673 Route 65
Ellwood City, PA 16117-5217

Mailing address

1673 Route 65
Ellwood City, PA 16117-5217
Phone (724) 758-7559

Other names 1

  • AHN ELLWOOD PRIMARY CARE Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.ahn.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040310000602 PA Part B Supplier - Clinic/Group Practice 5395649586 Receives reassigned benefits from 3,418 practitioners
This NPI is an additional NPI on the enrollment

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0182828Ahn-Ellwood City Primary Care1673 Route 65, Ellwood City, PA 16117Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

1673 Route 65
Ellwood City, PA 16117
Phone (724) 752-8550

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611187200000",
    "number": "1376076760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1673 ROUTE 65",
            "city": "ELLWOOD CITY",
            "state": "PA",
            "postal_code": "161175217",
            "telephone_number": "724-758-7559",
            "fax_number": "724-758-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1673 ROUTE 65",
            "city": "ELLWOOD CITY",
            "state": "PA",
            "postal_code": "161175217",
            "telephone_number": "724-758-7559",
            "fax_number": "724-758-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEGHENY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-04",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A",
        "authorized_official_last_name": "WALTEMIRE",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "PROVIDER CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "724-272-9068"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.ahn.org",
            "affiliation": "N",
            "address_1": "1673 Route 65",
            "city": "Ellwood City",
            "state": "PA",
            "country_code": "US",
            "postal_code": "161175217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "AHN ELLWOOD PRIMARY CARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AHN ELLWOOD PRIMARY CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellwood City, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.