NPIMap

Organization Active NPI

Fayette Physician Network Inc

  • Internal Medicine Physician
  • Uniontown, PA
National Provider Identifier
1447624499
Registry record updated Nov 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
FAYETTE PHYSICIAN NETWORK INC
Practice address
20 Highland Park Dr
Uniontown, PA 15401-8922
Phone
(724) 438-4364
Fax
(724) 438-4720
NPI assigned
Nov 13, 2015
Last updated
Nov 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2015

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

Authorized official

Name
Mark Ehalt
Title
Sr.Director
Phone
(412) 432-5304

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

20 Highland Park Dr
Uniontown, PA 15401-8922

Mailing address

20 Highland Park Dr
Uniontown, PA 15401-8922
Phone (724) 438-4364

Other names 1

  • Pish Medical Associates Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141211000851 PA Part B Supplier - Clinic/Group Practice 3375865819 Receives reassigned benefits from 518 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Waynesburg, PA; Uniontown, PA; Pittsburgh, PA; Perryopolis, PA; Connellsville, PA; Carmichaels, PA; Brownsville, PA; Belle Vernon, PA…

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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": "1447372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447372800000",
    "number": "1447624499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 HIGHLAND PARK DR",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154018922",
            "telephone_number": "724-438-4364",
            "fax_number": "724-438-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HIGHLAND PARK DR",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154018922",
            "telephone_number": "724-438-4364",
            "fax_number": "724-438-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTE PHYSICIAN NETWORK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-13",
        "last_updated": "2015-11-13",
        "status": "A",
        "authorized_official_last_name": "EHALT",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "SR.DIRECTOR",
        "authorized_official_telephone_number": "412-432-5304"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pish Medical Associates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Uniontown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2015; 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.