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

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Corporate family (same tax ID) 41

Organizations that report the same tax identification number in the National Provider Directory.

View all 41

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
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 (42 organizations share this tax ID)
Part of
Excela Health Connellsville Internal Med-Dr Tiberio

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician
Group: 193400000X SINGLE SPECIALTY GROUP
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

IdentifierTypeStateIssuer
2010802OtherHIGHMARK INDEMNITY/TRAD.

Other names

  • Excela Health Behavioral Health Services-Frick Other name

Other providers in Mt Pleasant, PA

All providers in Mt Pleasant, PA · Psychiatry Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.