NPIMap

Organization Active NPI

Fayette Medical Associates Inc

Doing business as The Doctors Office Masontown

  • Family Medicine Physician
  • Masontown, PA
National Provider Identifier
1659345924
Registry record updated Nov 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAYETTE MEDICAL ASSOCIATES INC
Doing business as
The Doctors Office Masontown
Practice address
2175 McClellandtown Rd
Suite 201
Masontown, PA 15461-2593
Phone
(724) 583-2819
Fax
(724) 583-8550
NPI assigned
Feb 14, 2006
Last updated
Nov 4, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2011

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

Authorized official

Name
Charlene Pulice
Title
Medical Biller
Phone
(724) 425-8317

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

2175 McClellandtown Rd
Suite 201
Masontown, PA 15461-2593

Mailing address

112 Youngstown Rd
Suite 101
Lemont Furnace, PA 15456-1344
Phone (724) 425-8317

Other identifiers 7

IdentifierTypeStateIssuer
0015441410014MedicaidPA
1038270OtherPAGATEWAY
26024OtherPARAILROAD MEDICARE
356566OtherPAHIGHMARK
78017OtherPAUNISON
E034OtherPAUPMC
WC06OtherPAHEALTH AMERICA

Other names 1

  • The Doctors Office Masontown Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fayette Medical Associates Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

112 Youngstown Rd
Ste 101
Lemont Furnace, PA 15456
Phone (724) 432-5831

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320364800000",
    "number": "1659345924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 YOUNGSTOWN RD",
            "address_2": "SUITE 101",
            "city": "LEMONT FURNACE",
            "state": "PA",
            "postal_code": "154561344",
            "telephone_number": "724-425-8317",
            "fax_number": "724-425-8326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 MCCLELLANDTOWN RD",
            "address_2": "SUITE 201",
            "city": "MASONTOWN",
            "state": "PA",
            "postal_code": "154612593",
            "telephone_number": "724-583-2819",
            "fax_number": "724-583-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTE MEDICAL ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-14",
        "last_updated": "2011-11-04",
        "status": "A",
        "authorized_official_last_name": "PULICE",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_title_or_position": "MEDICAL BILLER",
        "authorized_official_telephone_number": "724-425-8317"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015441410014",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1038270",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "26024",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "356566",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "78017",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC",
            "identifier": "E034",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA",
            "identifier": "WC06",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Doctors Office Masontown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Masontown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.