NPIMap

Organization Active NPI

Northshore Clinical Associates, LLC

  • Neurology Physician
  • Erie, PA
National Provider Identifier
1487645917
Registry record updated Nov 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD030792E Issued in PA
Legal business name
NORTHSHORE CLINICAL ASSOCIATES, LLC
Practice address
120 E 2ND St
Third Floor
Erie, PA 16507-1537
Phone
(814) 452-8300
Fax
(814) 452-8308
NPI assigned
Nov 3, 2005
Last updated
Nov 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2012

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

Authorized official

Name
Mrs. Cheryl Seremet
Title
Billing and Credentialing Specialis
Phone
(814) 452-8248

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X MD030792E PA Primary

Addresses

Primary practice location

120 E 2ND St
Third Floor
Erie, PA 16507-1537

Mailing address

120 E 2ND St
Third Floor
Erie, PA 16507-1537
Phone (814) 452-8300

Other identifiers 2

IdentifierTypeStateIssuer
0018455840004MedicaidPA
C0988OtherPARAILROAD MEDICARE GROUP

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352678400000",
    "number": "1487645917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E 2ND ST",
            "address_2": "THIRD FLOOR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071537",
            "telephone_number": "814-452-8300",
            "fax_number": "814-452-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E 2ND ST",
            "address_2": "THIRD FLOOR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071537",
            "telephone_number": "814-452-8300",
            "fax_number": "814-452-8308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSHORE CLINICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2012-11-12",
        "status": "A",
        "authorized_official_last_name": "SEREMET",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "BILLING AND CREDENTIALING SPECIALIS",
        "authorized_official_telephone_number": "814-452-8248",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MD030792E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018455840004",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "C0988",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Nov 12, 2012; 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.