Keystone Rehabilitation Systems, Inc.

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

KEYSTONE REHABILITATION SYSTEMS, INC.

Doing business as

NovaCare Rehabilitation

Practice address

5930 Old French Rd
Erie, PA 16509-3656

Phone

(814) 860-7816

Fax

(814) 860-7818

NPI assigned

Jan 28, 2010

Last updated

Nov 21, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Michael E Tarvin

Title

Vice President & Secretary

Phone

(717) 972-1100

Specialties & licenses 1

Addresses

Other names 1

• NovaCare Rehabilitation Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619208824. Details of each certification follow.

• CCN 396887 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 396887

Legal name

NOVACARE REHABILITATION

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Jan 28, 2020

Last certification

Jan 28, 2020

Ownership / control type

Proprietary

Facility address

5930 Old French Road
Erie, PA 16509

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

{
    "created_epoch": "1264636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574294400000",
    "number": "1619208824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "address_2": "LEGAL DEPT",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5930 OLD FRENCH RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165093656",
            "telephone_number": "814-860-7816",
            "fax_number": "814-860-7818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE REHABILITATION SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-28",
        "last_updated": "2019-11-21",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VICE PRESIDENT & SECRETARY",
        "authorized_official_telephone_number": "717-972-1100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NovaCare Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sakthi Tiruchirapalli Kesavan, DDS
• Kessler Counseling Services, LLC
• Brady James Kesterholt, PA-C
• Eric Tyler Ketchel
• Keystone Rehabilitation Systems, Inc. (NovaCare Rehabilitation)
• Keystone Rehabilitation Systems, Inc. (NovaCare Rehabilitation)
• Abdullah Khaja
• Ahsan Masood Khan, MD
• Cyrus Mohammad Ali Khan, M.D.
• Mahwish Khan, M.D.

• Rehabilitation Clinic/Center in Erie, PA
• Providers in Erie, PA by specialty
• Rehabilitation Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.