NPIMap

Organization Active NPI

Dubois Regional Medical Center

  • Rehabilitation Hospital Unit
  • Du Bois, PA
National Provider Identifier
1396766184
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
135501 Issued in PA
Legal business name
DUBOIS REGIONAL MEDICAL CENTER
Practice address
100 Hospital Ave
Du Bois, PA 15801-1440
Phone
(814) 371-2200
Fax
(814) 375-4232
NPI assigned
Jul 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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 S. Sutika
Title
Chief Financial Officer
Phone
(814) 375-6104

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 135501 PA Primary

Addresses

Primary practice location

100 Hospital Ave
Du Bois, PA 15801-1440

Mailing address

PO Box 447
Du Bois, PA 15801-0447
Phone (814) 371-2200

Other identifiers 2

IdentifierTypeStateIssuer
1007740880102MedicaidPA
1042OtherPABLUE CROSS PROVIDER #

Other names 1

  • DuBois Regional Medical Center - Rehab Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080108000720 PA Part A Provider - Hospital 5890689715 Practice locations: Dubois, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396766184. Details of each certification follow.

Hospital certification: CCN 39T086

Legal name
DUBOIS REGIONAL MEDICAL CENTER
Doing business as
PENN HIGHLANDS DUBOIS
Organization structure
CorporationNon-profit
Incorporated
Aug 25, 1955 in PA
Enrollment address
100 Hospital Avenue
Dubois, PA 15801-1440
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

View all 28

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Penn Highlands DuboisCCN 39T086 · All quality measures
Ownership
Non-profit
Certified
Jul 1, 1995

National Provider Directory

National Provider Directory
Tax ID family
Du Bois Regional Med CT123 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All disclosed owners & managing parties 21

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jourdan D Strishock Individual W-2 Managing EmployeeCompliance Supervisor Aug 1, 2021
Thomas a Carnevale Individual Corporate DirectorBoard Member Jul 1, 2021
Fred Price Individual Corporate DirectorBoard Member Jul 1, 2022
Penn Highlands Healthcare, Inc. Organization, Dubois, PA Corporation Other Oct 1, 2011 100%
Robert W O'Leary Individual Corporate DirectorBoard Member Jul 1, 2021
Joanne Ryan Individual Corporate DirectorBoard Member Jul 1, 2022
David Lezzer Individual Corporate DirectorBoard Member Jul 1, 2021
James E Devlin Individual Corporate DirectorBoard Member Jul 1, 2022
Lawrence Kiefer Individual Corporate DirectorBoard Member Jul 1, 2022
Todd P Stoltz Individual Corporate DirectorBoard Member Jul 1, 2022
Carlyn Belczyk Individual Corporate DirectorBoard Member Oct 1, 2021
Samuel Lewis Individual Corporate DirectorBoard Member Feb 1, 2021
Bradley Bassi Individual Corporate DirectorBoard Member Oct 1, 2021
Richard L Pfingstler Individual Corporate DirectorBoard Member Jul 1, 2021
Donald E Conrad Individual Corporate DirectorBoard Member Jul 1, 2021
Scott H Foradora Individual Corporate DirectorBoard Member Jul 1, 2020
Mark Norman Individual Corporate OfficerChief Operationg Officer Jul 1, 2016
W-2 Managing EmployeeAd; Jul 1, 2016
William H Young Individual Corporate DirectorBoard Member Jul 1, 2021
Mark McGinley Individual Corporate DirectorBoard Member Oct 1, 2021
James B Ryan Individual Corporate DirectorBoard Member Jul 1, 2020
Brian S Kline Individual Corporate OfficerChief Financial Officer Apr 23, 2013

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Penn Highlands BrookvilleBrookville, PA, CCN 391312 Hospital Operational/Managerial Control Sep 26, 2007
Dr Arthur Clifton McKinley Health CenterBrookville, PA, CCN 395550 Skilled nursing facility 5% Or Greater Indirect Ownership Interest
Operational/Managerial Control
Adp of the SNF		 Dec 31, 2021
Jan 1, 2024
Sep 25, 2025
Penn Highlands Jefferson ManorBrookville, PA, CCN 395626 Skilled nursing facility 5% Or Greater Indirect Ownership Interest
Adp of the SNF		 Apr 1, 2019
Dec 9, 2025
Penn Highlands BrookvillePhilipsburg, PA, CCN 393430 Rural health clinic Operational/Managerial Control (100%) Oct 1, 2011

Practitioners & affiliated clinicians

Affiliated clinicians 11

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396766184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 447",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158010447",
            "telephone_number": "814-371-2200",
            "fax_number": "814-375-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-371-2200",
            "fax_number": "814-375-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUBOIS REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SUTIKA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "814-375-6104"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "PA",
            "license": "135501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007740880102",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "1042",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DuBois Regional Medical Center - Rehab",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Du Bois, PA

Sources for this page

Verify at the official NPI Registry.