NPIMap

Organization Active NPI

Pediatric Care Center of Erie, PC

  • Pediatrics Physician
  • Erie, PA
National Provider Identifier
1487153144
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD440507 Issued in PA
Legal business name
PEDIATRIC CARE CENTER OF ERIE, PC
Practice address
1611 Peach St Ste 300
Erie, PA 16501-2122
Phone
(814) 454-2891
NPI assigned
Feb 8, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Authorized official

Name
Dr. Ravi Chekka, MDNPI 1467626283
Title
President
Phone
(814) 454-2891

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X MD440507 PA Primary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X MD419696 PA
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X MD038253L PA

Addresses

Primary practice location

1611 Peach St Ste 300
Erie, PA 16501-2122

Mailing address

1611 Peach St Ste 300
Erie, PA 16501-2122
Phone (814) 454-2891

Other identifiers 4

IdentifierTypeStateIssuer
1770550063MedicaidPA
MD440507OtherPAPA STATE LICENSE
1467626283MedicaidPA
1811976020MedicaidPA

Other names 1

  • Pediatric Care Center of Erie Other name

National Provider Directory

National Provider Directory

Locations

1611 Peach St
Ste 300
Erie, PA 16501
Phone (814) 454-2891

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1518048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601510400000",
    "number": "1487153144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 PEACH ST STE 300",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165012122",
            "telephone_number": "814-454-2891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 PEACH ST STE 300",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165012122",
            "telephone_number": "814-454-2891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CARE CENTER OF ERIE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-08",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A",
        "authorized_official_last_name": "CHEKKA",
        "authorized_official_first_name": "RAVI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-454-2891",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD440507",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD419696",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD038253L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770550063",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA STATE LICENSE",
            "identifier": "MD440507",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467626283",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811976020",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Care Center of Erie",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Oct 1, 2020; 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.