Individual provider Active NPI

Jonathan Richard Siuta, M.D.

  • Hospitalist Physician
  • State College, PA
National Provider Identifier
1639136872
Registry record updated Mar 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD449631 Issued in PA
Practice address
1800 E Park Ave
State College, PA 16803-6709
Phone
(814) 278-4818
Fax
(814) 234-6150
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD449631 PA
Pediatrics Physician 208000000X MD449631 PA
Hospitalist Physician 208M00000X MD449631 PA Primary

Addresses

Primary practice location

1800 E Park Ave
State College, PA 16803-6709

Mailing address

1800 E Park Ave
State College, PA 16803-6709
Phone (814) 278-4818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131029000533 PA Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Pediatric Medicine 7517973795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine, Pediatric Medicine
Education
State University of New York at Buffalo School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

129 Medical Park LN
Bellefonte, PA 16823-9112
Phone (814) 355-3626

141 Medical Park LN
Bellefonte, PA 16823-9112
Phone (814) 355-7322

143 Hospital Dr
State College, PA 16803-5500
Phone (814) 237-3470

155 Wellness Way
State College, PA 16803-6702

155 Wellness Way
State College, PA 16803-6797
Phone (814) 231-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Nittany Medical Center Health Services Inc Internal Medicine CurrentSince Jan 1, 2014 Accepting new patients
Mount Nittany Medical Center Health Services Inc Past Accepting new patients
Mount Nittany Medical Center Past Accepting new patients

Locations

141 Medical Park Ln
Bellefonte, PA 16823
Phone (814) 355-7322

129 Medical Park Ln
Bellefonte, PA 16823
Phone (814) 355-2762

3901 S Atherton St
Ste 2
State College, PA 16801
Phone (814) 278-4631

155 Wellness Way
State College, PA 16803
Phone (800) 367-0179

1850 E Park Ave
Ste 201
State College, PA 16803
Phone (814) 234-8800

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426809600000",
    "number": "1639136872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 E PARK AVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036709",
            "telephone_number": "814-278-4818",
            "fax_number": "814-234-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E PARK AVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036709",
            "telephone_number": "814-278-4818",
            "fax_number": "814-234-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIUTA",
        "first_name": "JONATHAN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2015-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD449631",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD449631",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD449631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.