NPIMap

Organization Active NPI

Warren General Hospital

Doing business as d/b/a Warren Medical Group

  • Family Medicine Physician
  • Warren, PA
National Provider Identifier
1508803701
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD429343 Issued in PA
Legal business name
WARREN GENERAL HOSPITAL
Doing business as
d/b/a Warren Medical Group
Practice address
2 Crescent Park W
Warren, PA 16365-2111
Phone
(814) 723-3300
Fax
(814) 723-8952
NPI assigned
May 31, 2006
Last updated
Jul 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Authorized official

Name
Mrs. Julie Snyder
Title
Executive Director of Finance
Phone
(814) 723-3300

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU
Family Medicine Physician 207Q00000X MD054007L PA
Family Medicine Physician 207Q00000X MD431934 PA
Family Medicine Physician 207Q00000X MD434750 PA
Family Medicine Physician 207Q00000X MD429343 PA Primary
Internal Medicine Physician 207R00000X MD16519E PA
Internal Medicine Physician 207R00000X MD432887 PA
Internal Medicine Physician 207R00000X MD015867E PA
Ophthalmology Physician 207W00000X NU
Urology Physician 208800000X MD432670 PA
General Practice Physician 208D00000X MD016651E PA
Pediatric Urology Physician 2088P0231X MD432670 PA

Addresses

Primary practice location

2 Crescent Park W
Warren, PA 16365-2111

Mailing address

2 W Crescent Park
Warren, PA 16365-2111
Phone (814) 723-3300

Other practice location 1

900 Chestnut Street Ext # A
Bradford, PA 16701-2298
Phone (814) 723-3300

Other names 1

  • d/b/a Warren Medical Group Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address warrengeneralhospital@directaddress.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060412000247 PA Part B Supplier - Clinic/Group Practice 4880501402 Receives reassigned benefits from 56 practitioners
Practice locations: Warren, PA; Youngsville, PA; Sugar Grove, PA; Sheffield, PA
O20250918000042 PA Part A Provider - Critical Access Hospital 4880501402 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Youngsville, PA; Warren, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508803701. Details of each certification follow.

Hospital certification: CCN 391319

Legal name
WARREN GENERAL HOSPITAL
Doing business as
D/B/A LECOM HEALTH
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jan 14, 2026
Last certification
Dec 29, 2025
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
2 W Crescent Park
Warren, PA 16365-2111
Main/Primary Hospital Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

103 W Saint Clair St
Rm 1A
Warren, PA 16365
Phone (814) 726-2020

12 Elm St
Warren, PA 16365
Phone (814) 452-8300

2 W Crescent Park
Fl 2
Warren, PA 16365
Phone (814) 723-0407

Ownership & related parties

All disclosed owners & managing parties 24

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Care Corporation of Warren Organization, Warren, PA Non-profit 5% Or Greater Direct Ownership Interest Apr 13, 1987 55%
Laurie Macdonald Individual Corporate OfficerChief Financial Officer May 15, 2023
Operational/Managerial ControlChief Financial Officer May 15, 2023
Allegheny Health Network Organization, Pittsburgh, PA Non-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 31, 2018 22.5%
Julia McTavish Individual OtherBoard Member Sep 1, 2018
Vikas Sacher Individual OtherBoard Member Jan 1, 2025
Lecom Health Affiliates, LLC Organization, Erie, PA LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 31, 2018 22.5%
Highmark Health Organization, Pittsburgh, PA Non-profit 5% Or Greater Indirect Ownership Interest Aug 31, 2018 22.5%
Mason Tootell Individual OtherBoard Member Sep 1, 2018
Gwendolynn Scutella Individual OtherBoard Member Jul 1, 2024
Ahn-Lecom JV LLC Organization, Pittsburgh, PA Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 31, 2018 45%
Timothy Scott Stanton Individual OtherBoard Member Sep 1, 2018
Kathryn Carlson Individual Corporate OfficerChief Operating Officer Jul 1, 2025
Operational/Managerial ControlChief Operating Officer Jul 1, 2025
Brian Devine Individual OtherBoard Vice-Chairman Dec 19, 2023
Thad Turner Individual OtherBoard Chairman Sep 1, 2018
Timothy Bevevino Individual OtherBoard Secretary Sep 1, 2018
Millcreek Health System Organization, Erie, PA Non-profit 5% Or Greater Indirect Ownership Interest Aug 31, 2018 22.5%
Steven Inman Individual OtherBoard Member Dec 19, 2023
Karen Surkala Individual OtherBoard Member Apr 23, 2020
Trevor Olsen Individual OtherBoard Member Sep 1, 2018
Joseph J Maljovec Individual OtherBoard Member Jan 1, 2020
Whitney Morrison Individual OtherDirector of Credentialing Aug 8, 2022
Jasen Diley Individual OtherBoard Member Sep 1, 2018
Randall Scalise Individual OtherBoard Member Mar 2, 2022
Daniel W Grolemund Individual Corporate OfficerChief Executive Officer Jul 1, 2025
W-2 Managing EmployeeAd; Jul 1, 2025 100%
Operational/Managerial ControlChief Executive Officer Jul 1, 2025 100%

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Warren General HospitalWarren, PA, CCN 393458 Rural health clinic 5% Or Greater Direct Ownership Interest (55%) Sep 1, 2018
Warren General Hospital RHC Sugar GroveSugar Grove, PA, CCN 393456 Rural health clinic 5% Or Greater Direct Ownership Interest (55%) Sep 1, 2018
Warren General HospitalWarren, PA, CCN 393457 Rural health clinic 5% Or Greater Direct Ownership Interest (55%) Sep 1, 2018

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 78

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 78

Affiliated clinicians 199

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 199

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784592000000",
    "number": "1508803701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 W CRESCENT PARK",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163652111",
            "telephone_number": "814-723-3300",
            "fax_number": "814-723-8515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CRESCENT PARK W",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163652111",
            "telephone_number": "814-723-3300",
            "fax_number": "814-723-8952"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Chestnut Street Ext # A",
            "address_purpose": "LOCATION",
            "city": "Bradford",
            "state": "PA",
            "postal_code": "167012298",
            "country_code": "US",
            "telephone_number": "814-723-3300",
            "fax_number": "814-723-8515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WARREN GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "814-723-3300",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD054007L",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD431934",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD434750",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD429343",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD16519E",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD432887",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD015867E",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MD432670",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PA",
            "license": "MD016651E",
            "primary": false
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "PA",
            "license": "MD432670",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "warrengeneralhospital@directaddress.net",
            "affiliation": "N",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Summary of Care",
            "address_1": "2 Crescent Park W",
            "city": "Warren",
            "state": "PA",
            "country_code": "US",
            "postal_code": "163652111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "d/b/a Warren Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "d/b/a Warren Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warren, PA

Sources for this page

Verify at the official NPI Registry.