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Organization Active NPI

Meadville Medical Center

  • Otolaryngology Physician
  • Meadville, PA
National Provider Identifier
1649026162
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
MEADVILLE MEDICAL CENTER
Practice address
11277 Vernon PL Ste 1400
Meadville, PA 16335-3717
Phone
(814) 373-3070
Fax
(814) 373-3074
NPI assigned
Apr 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Authorized official

Name
Renato J Suntay
Title
Cfo
Phone
(814) 333-5030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

11277 Vernon PL Ste 1400
Meadville, PA 16335-3717

Mailing address

1034 Grove St
Meadville, PA 16335-2945
Phone (814) 333-5000

Other practice location 1

315 S Erie St Ste E
Mercer, PA 16137-1555
Phone (724) 458-0511

Other names 1

  • MMC ENT Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240711004341 PA Part B Supplier - Hospital Department(S) 4284535790 Receives reassigned benefits from 3 practitioners
Practice locations: Grove City, PA; Mercer, PA; Meadville, PA

Other NPIs with the same Medicare PAC ID 20

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

View all 20

National Provider Directory

National Provider Directory

Locations

647 N Broad Street Ext
Ste 206
Grove City, PA 16127
Phone (724) 450-7004

315 S Erie St
Mercer, PA 16137
Phone (724) 662-2240

Ownership & related parties

All facility ownership & control disclosures 8

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

FacilityTypeRoleSince
Meadville Medical CenterMeadville, PA, CCN 390113 Hospital Operational/Managerial Control Sep 15, 2008
Titusville Area HospitalTitusville, PA, CCN 391314 Hospital 5% Or Greater Indirect Ownership Interest Oct 1, 2015
Titusville Area HospitalTitusville, PA, CCN 39Z314 Hospital 5% Or Greater Indirect Ownership Interest Oct 1, 2015
Vna AllianceMeadville, PA, CCN 397655 Home health agency 5% Or Greater Direct Ownership Interest (25%) Jun 28, 2023
Titusville Area HospitalTitusville, PA, CCN 393438 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Oct 1, 2015
Titusville Area HospitalTitusville, PA, CCN 393442 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Oct 1, 2015
Titusville Area HospitalOil City, PA, CCN 393441 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Oct 1, 2015
Tionesta Health CenterTionesta, PA, CCN 393449 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Oct 1, 2015

Owned or controlled facilities with NPI records 8

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

Practitioners & affiliated clinicians

Practitioners 139

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 139

NPI Registry JSON

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

{
    "created_epoch": "1714003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736726400000",
    "number": "1649026162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 GROVE ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352945",
            "telephone_number": "814-333-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11277 VERNON PL STE 1400",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163353717",
            "telephone_number": "814-373-3070",
            "fax_number": "814-373-3074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 S Erie St Ste E",
            "address_purpose": "LOCATION",
            "city": "Mercer",
            "state": "PA",
            "postal_code": "161371555",
            "country_code": "US",
            "telephone_number": "724-458-0511",
            "fax_number": "724-458-1517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEADVILLE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-25",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A",
        "authorized_official_last_name": "SUNTAY",
        "authorized_official_first_name": "RENATO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "814-333-5030"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MMC ENT",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "MMC ENT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Meadville, PA

Sources for this page

Verify at the official NPI Registry.