Excela Health Physician Practices, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

EXCELA HEALTH PHYSICIAN PRACTICES, INC

Practice address

2618 Memorial Blvd Ste B-1
Connellsville, PA 15425-1419

Phone

(724) 628-3944

NPI assigned

Mar 6, 2020

Organization subpart

Yes

Parent organization

EXCELA HEALTH HOLDING COMPANYAs reported in NPPES

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

Authorized official

Name

Renee M Varney

Title

Credentialing Coordinator

Phone

(724) 850-6933

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 7

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

• Brenda Bellissimo

  • Medical Physician Assistant
  • Pittsburgh, PA
  • NPI 1306920889
  NPD
• Megan Gerhard, MHS, PA-C

  • Medical Physician Assistant
  • North Huntingdon, PA
  • NPI 1194343699
  NPD
• Michele L Jacobson, D.O.

  • Obstetrics & Gynecology Physician
  • Latrobe, PA
  • NPI 1235115221
  NPD
• Ashok Movva

  • Internal Medicine Physician
  • Seneca, PA
  • NPI 1104249135
  NPD
• Kimberlee Suter

  • Medical Physician Assistant
  • Connellsville, PA
  • NPI 1275934010
  NPD
• Jonathan R Thiele, CRNA

  • Certified Registered Nurse Anesthetist
  • Chambersburg, PA
  • NPI 1205131653
  NPD
• Nicholas Frederick Willison, DO

  • Anesthesiology Physician
  • Greensburg, PA
  • NPI 1174102826
  NPD

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

{
    "created_epoch": "1583452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583452800000",
    "number": "1497380885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 INDUSTRIAL PARK RD STE 1500",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156018153",
            "telephone_number": "724-850-6933",
            "fax_number": "724-522-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2618 MEMORIAL BLVD STE B-1",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154251419",
            "telephone_number": "724-628-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELA HEALTH PHYSICIAN PRACTICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXCELA HEALTH HOLDING COMPANY",
        "enumeration_date": "2020-03-06",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A",
        "authorized_official_last_name": "VARNEY",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "724-850-6933"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emergency Solutions Highlands Inc
• Albert Kelly Enany II, MD
• Danielle Lee Etling, RPH
• Excela Health Connellsville Internal Med-Dr. Tiberio
• Excela Health Physician Practices
• Fayette EMS
• Fayette Medical Associates Inc
• Fayette Physician Network Inc
• Fayette Physician Network Inc
• Fayette Specialty Associates

• Family Medicine Physician in Connellsville, PA
• Providers in Connellsville, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.