NPIMap

Organization Active NPI

Millcreek Community Hospital

  • Family Medicine Physician
  • Albion, PA
National Provider Identifier
1427893791
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MILLCREEK COMMUNITY HOSPITAL
Practice address
210 E State St
Albion, PA 16401-1306
Phone
(814) 756-3434
Fax
(814) 756-4725
NPI assigned
Jun 28, 2024
Last updated
Jun 28, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MILLCREEK COMMUNITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Podiatrist 213E00000X
Family Nurse Practitioner 363LF0000X

Addresses

Primary practice location

210 E State St
Albion, PA 16401-1306

Mailing address

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240712003038 PA Part B Supplier - Hospital Department(S) 8426020173 Receives reassigned benefits from 3 practitioners
Practice locations: Albion, PA

Other NPIs with the same Medicare PAC ID 23

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 23

National Provider Directory

National Provider Directory
Tax ID family
Eastside Medical Center34 organizations share this tax ID, including this one
Part of
Eastside Medical Center

Other organizations with this tax ID 33

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

View all 33

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1427893791",
    "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": "210 E STATE ST",
            "city": "ALBION",
            "state": "PA",
            "postal_code": "164011306",
            "telephone_number": "814-756-3434",
            "fax_number": "814-756-4725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLCREEK COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MILLCREEK COMMUNITY HOSPITAL",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "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": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albion, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.