Mount Nittany Medical Center Health Services Inc

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES INC

Practice address

911 University Drive
State College, PA 16801-6626

Phone

(814) 237-3360

NPI assigned

Oct 25, 2007

Last updated

Oct 4, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

MOUNT NITTANY MEDICAL CENTRAL HEALTH SERVICES INCAs reported in NPPES

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

Authorized official

Name

Bryan Roach

Title

Cfo

Phone

(814) 234-6148

Specialties & licenses 1

Addresses

Other names 1

• MNMC Pain Management Clinic Other name

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

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

• Mount Nittany Medical Center Health Services Inc

  • Family Medicine Physician
  • Spring Mills, PA
  • NPI 1164691499

  O20081021000240

  Same enrollment
• Mount Nittany Medical Center Health Services Inc

  • Clinic/Center
  • State College, PA
  • NPI 1245418334

  O20081021000240

  Same enrollment
• Mount Nittany Medical Center Health Services Inc

  dba Mount Nittany Physician Group

  • Internal Medicine Physician
  • State College, PA
  • NPI 1598992554

  O20081021000240

  Same enrollment

Part of

Mount Nittany Med Ctr HLTH

Locations

Practitioners 194

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.

• Catherine Adams, MD

  • Pulmonary Disease Physician
  • State College, PA
  • NPI 1457840076
  NPD (past)
• Aderonke Ajala, MD

  • Hematology & Oncology Physician
  • State College, PA
  • NPI 1689015042
  NPD (past)
• Cynthia D Alexander, MD

  • Internal Medicine Physician
  • Bellefonte, PA
  • NPI 1255302600
  NPD (past)
• Asna A Amin, M.D.

  • Colon & Rectal Surgery Physician
  • State College, PA
  • NPI 1649474925
  NPD (past)
• Manasi Badve, MD

  • Family Medicine Physician
  • State College, PA
  • NPI 1831403906
  NPD (past)
• Tamar Baitel, M.D.

  • Family Medicine Physician
  • Spring Mills, PA
  • NPI 1952665259
  NPD (past)
• Ralitsa V Balabanova-Tsarnakova, MD

  • Internal Medicine Physician
  • State College, PA
  • NPI 1164731303
  NPD (past)
• Chase William Bamat, PA-C

  • Physician Assistant
  • State College, PA
  • NPI 1659723559
  NPD (past)
• Maria Basedow, DO

  • Family Medicine Physician
  • State College, PA
  • NPI 1689108060
  NPD (past)
• Diana Berlyand, R.D.

  • Registered Dietitian
  • State College, PA
  • NPI 1902972086
  NPD (past)
• Daniel Thomas Bigart, AU.D.

  • Audiologist
  • State College, PA
  • NPI 1235268855
  NPD (past)
• Michelle M. Black, CRNP

  • Adult Health Nurse Practitioner
  • State College, PA
  • NPI 1083902316
  NPD (past)

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

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633305600000",
    "number": "1407035553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 EAST PARK AVENUE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036797",
            "telephone_number": "814-231-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 UNIVERSITY DRIVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168016626",
            "telephone_number": "814-237-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOUNT NITTANY MEDICAL CENTRAL HEALTH SERVICES INC",
        "enumeration_date": "2007-10-25",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A",
        "authorized_official_last_name": "ROACH",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "814-234-6148"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MNMC Pain Management Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "MNMC Pain Management Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mount Nittany Medical Center
• Mount Nittany Medical Center
• Mount Nittany Medical Center
• Mount Nittany Medical Center Health Services Inc
• Mount Nittany Medical Center Health Services Inc
• Mount Nittany Medical Center Health Services Inc (Mount Nittany Physician Group)
• Mount Nittany Medical Center Health Services Inc (Mount Nittany Physician Group)
• Mount Nittany Medical Center Health Services Inc (Mount Nittany Physician Group)
• Mount Nittany Medical Center Health Services, Inc.
• Cindra A. Mowen

• Pain Clinic/Center in State College, PA
• Providers in State College, PA by specialty
• Pain Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; 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.