NPIMap

Organization Active NPI

FRG Central PA PC

  • Diagnostic Radiology Physician
  • Coudersport, PA
National Provider Identifier
1487805693
Registry record updated May 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
FRG CENTRAL PA PC
Practice address
1001 E 2ND St
Coudersport, PA 16915-8161
Phone
(814) 274-9300
NPI assigned
Oct 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2009

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

Authorized official

Name
Timothy J. Pisula
Title
Coo
Phone
(412) 551-0011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

1001 E 2ND St
Coudersport, PA 16915-8161

Mailing address

PO Box 60
Pittsburgh, PA 15230-0060
Phone (412) 937-5726

Other identifiers 1

IdentifierTypeStateIssuer
1022369280001MedicaidPA

National Provider Directory

National Provider Directory

Locations

75 Remittance Dr
#8173
Chicago, IL 60675

75 Remittance Dr
Ste 8173
Chicago, IL 60675

1000 Alliance Dr
#10
Hazleton, PA 18202
Phone (570) 501-6450

401 Liberty Ave
Ste 2000
Pittsburgh, PA 15222
Phone (412) 325-2800

Practitioners & affiliated clinicians

Practitioners 41

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

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242777600000",
    "number": "1487805693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152300060",
            "telephone_number": "412-937-5726",
            "fax_number": "412-937-5706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E 2ND ST",
            "city": "COUDERSPORT",
            "state": "PA",
            "postal_code": "169158161",
            "telephone_number": "814-274-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRG CENTRAL PA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-07",
        "last_updated": "2009-05-20",
        "status": "A",
        "authorized_official_last_name": "PISULA",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "412-551-0011"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022369280001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coudersport, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; 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.