Individual provider Active NPI

Christian Ryan Pergola, CRNP

  • Family Nurse Practitioner
  • Butler, PA
National Provider Identifier
1417775461
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP030697 Issued in PA
Practice address
127 Oneida Valley Rd
Butler, PA 16001-2239
Phone
(724) 284-4804
NPI assigned
Sep 30, 2024
Last updated
Sep 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP030697 PA Primary

Addresses

Primary practice location

127 Oneida Valley Rd
Butler, PA 16001-2239

Mailing address

3417 E Stag Dr
Gibsonia, PA 15044-7975

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241023004933 PA Practitioner - Nurse Practitioner 5496288821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Butler Medical ProvidersGroup PAC ID 7416840160, 355 clinicians

Practice addresses (Care Compare)

127 Oneida Valley Rd
Suite 400
Butler, PA 16001-2251
Phone (866) 620-6761

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Butler Medical Providers CurrentSince Sep 9, 2024 Accepting new patients
Butler Medical Providers CurrentSince Sep 9, 2024 Accepting new patients
Butler Medical Providers Current Accepting new patients
Butler Medical Providers Past Accepting new patients
Butler Medical Providers Past Accepting new patients

Locations

127 Oneida Valley Rd
Ste 400
Butler, PA 16001
Phone (724) 431-0550

24 Doctors Ln
Ste 201
Clarion, PA 16214
Phone (833) 684-1898

330 N Point Dr
Ste 301
Clarion, PA 16214
Phone (814) 393-6052

21 Franklin Village Mall
Ste 1
Kittanning, PA 16201

1 Park Way
Seneca, PA 16346
Phone (814) 676-5444

100 Innovation Dr
Ste 103
Slippery Rock, PA 16057
Phone (724) 738-0912

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1417775461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 E STAG DR",
            "city": "GIBSONIA",
            "state": "PA",
            "postal_code": "150447975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 ONEIDA VALLEY RD",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "160012239",
            "telephone_number": "724-284-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERGOLA",
        "first_name": "CHRISTIAN",
        "middle_name": "RYAN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP030697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Butler, PA

Sources for this page

Verify at the official NPI Registry.