Centre Medical and Surgical Associates, P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD067664L Issued in PA

Legal business name

CENTRE MEDICAL AND SURGICAL ASSOCIATES, P.C.

Practice address

1850 E Park Ave
Suite 302
State College, PA 16803-6706

Phone

(814) 234-8800

Fax

(814) 234-8068

NPI assigned

May 1, 2006

Organization subpart

No

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

Authorized official

Name

John McQueary

Title

Coo/Administrative Director

Phone

(814) 234-4753

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Primary Care Physicians Other name

Tax ID family

Centre Medical and Surgical Associates PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Centre Medical and Surgical Associates, P.C.

  • Radiology Clinic/Center
  • State College, PA
  • NPI 1174587513
  NPD tax ID
• Centre Medical and Surgical Associates, P.C.

  • Advanced Practice Midwife
  • State College, PA
  • NPI 1235194036
  NPD tax ID
• Centre Medical and Surgical Associates, P.C.

  • Internal Medicine Physician
  • State College, PA
  • NPI 1306803531
  NPD tax ID

Locations

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487611612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 E PARK AVE",
            "address_2": "SUITE 302",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036706",
            "telephone_number": "814-234-8800",
            "fax_number": "814-234-8068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 E PARK AVE",
            "address_2": "SUITE 302",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036706",
            "telephone_number": "814-234-8800",
            "fax_number": "814-234-8068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRE MEDICAL AND SURGICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCQUEARY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "COO/ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "814-234-4753"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD067664L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "03045400",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Care Physicians",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Centre Medical and Surgical Associates, P.C.
• Centre Medical and Surgical Associates, P.C.
• Centre Medical and Surgical Associates, P.C.
• Centre Medical and Surgical Associates, P.C.
• Centre Medical and Surgical Associates, P.C.
• Centre Medical and Surgical Associates, P.C.
• Centre Medical and Surgical Associates, P.C.
• Centre Medical and Surgical Associates, P.C., Dept of OB/GYN
• Centre Optical Services, Inc.
• Centre Oral & Facial Surgery, P.C.

• Internal Medicine Physician in State College, PA
• Providers in State College, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.