Excela Health Physician Practices, Inc.
Organization Active NPI Psychiatry Physician · Mt Pleasant, PA
NPI 1497937635 · NPPES record last updated Mar 24, 2008
Key facts
- NPI
- 1497937635
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- EXCELA HEALTH PHYSICIAN PRACTICES, INC.
- Practice address
- 508 S Church St
Mt Pleasant, PA 15666-1702 - Phone
- (724) 547-1500
- NPI assigned
- Nov 29, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- EXCELA HEALTH PHYSICIAN PRACTICES, INC.
Authorized official
- Name
- John M. Sphon
- Title
- Vice President
- Phone
- (724) 830-8500
Parent organization (reported in NPPES) 1
Corporate family (same tax ID) 41
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040322001393 | PA | Part B Supplier - Clinic/Group Practice | 6204737117 |
Receives reassigned benefits from 767 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Excela Health Connellsville Internal Med-Dr Tiberio
- Part of
- Excela Health Connellsville Internal Med-Dr Tiberio
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician |
2084P0800X | Yes |
Addresses
Primary practice location
508 S Church St
Mt Pleasant, PA 15666-1702
Mailing address
134 Industrial Park Rd Ste 2300a
Greensburg, PA 15601-7328
Phone (724) 689-1810
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2010802 | Other | HIGHMARK INDEMNITY/TRAD. |
Other names
- Excela Health Behavioral Health Services-Frick
Other providers in Mt Pleasant, PA
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- Excela Health Physician Practices, Inc.
- Excela Health Physician Practices, Inc.
- Excela Health Physician Practices, Inc.
- Excela Health Physician Practices, Inc.
- Excela Health Physician Practices, Inc.
- Excela Health Physician Practices, Inc..
All providers in Mt Pleasant, PA · Psychiatry Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.