NPIMap

Organization Active NPI

Medical Associates of Erie

Doing business as Sports Medicine and Integrative Care

  • Sports Medicine (Preventive Medicine) Physician
  • Erie, PA
National Provider Identifier
1447419536
Registry record updated Jun 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Preventive Medicine) PhysicianTaxonomy code 2083S0010X
Legal business name
MEDICAL ASSOCIATES OF ERIE
Doing business as
Sports Medicine and Integrative Care
Practice address
5515 Peach St
Erie, PA 16509-2603
Phone
(814) 864-4031
NPI assigned
Jun 4, 2008
Last updated
Jun 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2008

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

Authorized official

Name
Dennis Styn
Title
President
Phone
(814) 528-9709

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Preventive Medicine) Physician 2083S0010X NU Primary

Addresses

Primary practice location

5515 Peach St
Erie, PA 16509-2603

Mailing address

1 Lecom PL
Erie, PA 16505-2571
Phone (814) 528-9709

Other identifiers 1

IdentifierTypeStateIssuer
101066458MedicaidPA

Other names 1

  • Sports Medicine and Integrative Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medical Associates of Erie Inc36 organizations share this tax ID, including this one

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": "1212537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212537600000",
    "number": "1447419536",
    "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": "814-528-9709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5515 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092603",
            "telephone_number": "814-864-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES OF ERIE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-04",
        "last_updated": "2008-06-04",
        "status": "A",
        "authorized_official_last_name": "STYN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-528-9709"
    },
    "taxonomies": [
        {
            "code": "2083S0010X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101066458",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sports Medicine and Integrative 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 Jun 4, 2008; 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.