NPIMap

Organization Active NPI

Medical Associates of Erie

Doing business as West Grandview Primary Care

  • Family Medicine Physician
  • Erie, PA
National Provider Identifier
1417660952
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEDICAL ASSOCIATES OF ERIE
Doing business as
West Grandview Primary Care
Practice address
2000 W Grandview Blvd
Erie, PA 16509-1029
Phone
(814) 868-1088
Fax
(814) 868-1094
NPI assigned
Dec 29, 2022
Organization subpart
Yes
Parent organization
MEDICAL ASSOCIATES OF ERIEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Authorized official

Name
Jean Nejman
Title
Credentialing Specialist
Phone
(814) 868-2507

Specialties & licenses 1

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

Addresses

Primary practice location

2000 W Grandview Blvd
Erie, PA 16509-1029

Mailing address

1 Lecom PL
Erie, PA 16505-2571
Phone (814) 868-2529

Other names 1

  • West Grandview Primary Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Eastside Medical Center36 organizations share this tax ID, including this one
Part of
Eastside Medical Center

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1672272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672272000000",
    "number": "1417660952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LECOM PL",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165052571",
            "telephone_number": "814-868-2529",
            "fax_number": "814-868-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W GRANDVIEW BLVD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165091029",
            "telephone_number": "814-868-1088",
            "fax_number": "814-868-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES OF ERIE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDICAL ASSOCIATES OF ERIE",
        "enumeration_date": "2022-12-29",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-28",
        "status": "A",
        "authorized_official_last_name": "NEJMAN",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "814-868-2507"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Grandview Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.