Individual provider Active NPI

Joseph E. Ambrose, D.O.

  • Internal Medicine Physician
  • Indiana, PA
National Provider Identifier
1467451476
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS-0044831-L Issued in PA
Practice address
100 Christy Park Dr
Indiana, PA 15701-1584
Phone
(724) 349-9430
Fax
(724) 349-9431
NPI assigned
Jul 20, 2005
Last updated
Oct 1, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS-0044831-L PA Primary

Addresses

Primary practice location

100 Christy Park Dr
Indiana, PA 15701-1584

Mailing address

100 Christy Park Dr
Indiana, PA 15701-1584
Phone (724) 349-9430

Other identifiers 2

IdentifierTypeStateIssuer
0009281810005MedicaidPA
AM462289OtherPAPA BLUE SHIELD

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS-0044831-LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Windber Hospital, Inc. Past Accepting new patients
Joseph E Ambrose DO Internal Medicine PastSince Jan 1, 1990 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3258/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1467451476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CHRISTY PARK DR",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157011584",
            "telephone_number": "724-349-9430",
            "fax_number": "724-349-9431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CHRISTY PARK DR",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157011584",
            "telephone_number": "724-349-9430",
            "fax_number": "724-349-9431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSE",
        "first_name": "JOSEPH",
        "middle_name": "E.",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS-0044831-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009281810005",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BLUE SHIELD",
            "identifier": "AM462289",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indiana, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; 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.