NPIMap

Organization Active NPI

Prostat, Inc.

  • Home Health Agency
  • Reading, PA
National Provider Identifier
1487906632
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
23393601 Issued in PA
Legal business name
PROSTAT, INC.
Practice address
1901 Bernville Rd
Reading, PA 19601-1113
Phone
(610) 736-9000
Fax
(610) 736-9006
NPI assigned
Oct 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Authorized official

Name
Mr. David Eugene Shelly
Title
Coo
Phone
(570) 225-7090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 23393601 PA Primary

Addresses

Primary practice location

1901 Bernville Rd
Reading, PA 19601-1113

Mailing address

395 E Broad St
Tamaqua, PA 18252-2145
Phone (570) 225-7090

Other identifiers 3

IdentifierTypeStateIssuer
1024232050002MedicaidPA
1024232050001MedicaidPA
1024232050003MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Prostat Inc4 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.

Locations

395 E Broad St
Tamaqua, PA 18252
Phone (570) 668-3955

NPI Registry JSON

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

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350000000000",
    "number": "1487906632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 E BROAD ST",
            "city": "TAMAQUA",
            "state": "PA",
            "postal_code": "182522145",
            "telephone_number": "570-225-7090",
            "fax_number": "570-225-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 BERNVILLE RD",
            "city": "READING",
            "state": "PA",
            "postal_code": "196011113",
            "telephone_number": "610-736-9000",
            "fax_number": "610-736-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSTAT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-12",
        "last_updated": "2012-10-12",
        "status": "A",
        "authorized_official_last_name": "SHELLY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "570-225-7090",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "PA",
            "license": "23393601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024232050002",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024232050001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024232050003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reading, PA

Sources for this page

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