Individual provider Active NPI

Linda Maranowski Phillips, PA-CERTIFIED

  • Medical Physician Assistant
  • Stoystown, PA
National Provider Identifier
1417909391
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA000081L Issued in PA
Practice address
136 S Pine Ave
Box 340
Stoystown, PA 15563-6002
Phone
(814) 893-5568
Fax
(814) 893-5989
NPI assigned
May 17, 2006
Last updated
Dec 19, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA000081L PA Primary

Addresses

Primary practice location

136 S Pine Ave
Box 340
Stoystown, PA 15563-6002

Mailing address

430 Stonycreek St
Boswell, PA 15531-1024
Phone (814) 629-5612

Other identifiers 2

IdentifierTypeStateIssuer
1007698380001MedicaidPA
1007698380002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA000081LPAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Windber Hospital, Inc. Past Accepting new patients
Medical Associates of Boswell PastSince Jul 15, 2017 Accepting new patients
Medical Associates of Boswell Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198022400000",
    "number": "1417909391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 STONYCREEK ST",
            "city": "BOSWELL",
            "state": "PA",
            "postal_code": "155311024",
            "telephone_number": "814-629-5612",
            "fax_number": "814-629-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 S PINE AVE",
            "address_2": "BOX 340",
            "city": "STOYSTOWN",
            "state": "PA",
            "postal_code": "155636002",
            "telephone_number": "814-893-5568",
            "fax_number": "814-893-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "LINDA",
        "middle_name": "MARANOWSKI",
        "name_prefix": "Mrs.",
        "credential": "PA-CERTIFIED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2007-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA000081L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007698380001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007698380002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoystown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; 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.