NPIMap

Organization Active NPI

Indiana Healthcare Physician Services, Inc

  • Radiation Oncology Physician
  • Indiana, PA
National Provider Identifier
1417409186
Registry record updated Mar 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
INDIANA HEALTHCARE PHYSICIAN SERVICES, INC
Practice address
640 Kolter Dr
Indiana, PA 15701-3570
Phone
(724) 357-7196
Fax
(724) 357-7279
NPI assigned
Oct 28, 2016
Last updated
Mar 16, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
IHPSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 16, 2018

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

Authorized official

Name
Brett J Brett
Title
C.O.O.
Phone
(724) 357-8230

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Radiation Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0001X Primary

Addresses

Primary practice location

640 Kolter Dr
Indiana, PA 15701-3570

Mailing address

640 Kolter Dr
Indiana, PA 15701-3570
Phone (724) 357-7196

Other identifiers 1

IdentifierTypeStateIssuer
0017702500010MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040927000404 PA Part B Supplier - Clinic/Group Practice 5294723359 Receives reassigned benefits from 221 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Marion Center, PA; Kittanning, PA; Johnstown, PA; Indiana, PA; Nanty Glo, PA; New Alexandria, PA; Plumville, PA; Punxsutawney, PA…

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Part of
Irmc Urgicare at Indiana

Locations

145 Irmc Dr
Indiana, PA 15701
Phone (724) 357-7404

2128 Oakland Ave
Indiana, PA 15701
Phone (724) 349-2276

841 Hospital Rd
Ste 3200
Indiana, PA 15701
Phone (724) 463-1414

879 Hospital Rd
Indiana, PA 15701
Phone (724) 349-3031

Practitioners & affiliated clinicians

Practitioners 47

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 47

NPI Registry JSON

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

{
    "created_epoch": "1477612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521158400000",
    "number": "1417409186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 KOLTER DR",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013570",
            "telephone_number": "724-357-7196",
            "fax_number": "724-357-7279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 KOLTER DR",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013570",
            "telephone_number": "724-357-7196",
            "fax_number": "724-357-7279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA HEALTHCARE PHYSICIAN SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IHPS",
        "enumeration_date": "2016-10-28",
        "last_updated": "2018-03-16",
        "status": "A",
        "authorized_official_last_name": "BRETT",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "C.O.O.",
        "authorized_official_telephone_number": "724-357-8230"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017702500010",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indiana, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2018; 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.