NPIMap

Organization Active NPI

Osteopathic Internal Medicine Associates Inc.

  • Internal Medicine Physician
  • Erie, PA
National Provider Identifier
1649327792
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS003106L Issued in PA
Legal business name
OSTEOPATHIC INTERNAL MEDICINE ASSOCIATES INC.
Practice address
2010 W 38TH St
Erie, PA 16508-2004
Phone
(814) 868-5481
Fax
(814) 864-7608
NPI assigned
Jan 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Authorized official

Name
Jean Nejman
Title
Credentialing Specialist
Phone
(814) 868-2507

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X OS003106L PA Primary

Addresses

Primary practice location

2010 W 38TH St
Erie, PA 16508-2004

Mailing address

1 Lecom PL
Erie, PA 16505-2571
Phone (814) 868-2529

Other identifiers 1

IdentifierTypeStateIssuer
0007339400002OtherPAMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050425000160 PA Part B Supplier - Clinic/Group Practice 9739127234 Receives reassigned benefits from 5 practitioners
Practice locations: Erie, PA

National Provider Directory

National Provider Directory

Locations

2010 W 38th St
Lowr
Erie, PA 16508
Phone (814) 868-5481

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693353600000",
    "number": "1649327792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LECOM PL",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165052571",
            "telephone_number": "814-868-2529",
            "fax_number": "814-868-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 W 38TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082004",
            "telephone_number": "814-868-5481",
            "fax_number": "814-864-7608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSTEOPATHIC INTERNAL MEDICINE ASSOCIATES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A",
        "authorized_official_last_name": "NEJMAN",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "814-868-2507"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS003106L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MA",
            "identifier": "0007339400002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.