NPIMap

Organization Active NPI

Mon-Vale Primary Care Practices Inc

  • Family Medicine Physician
  • Rostraver Township, PA
National Provider Identifier
1669715843
Registry record updated Jan 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MON-VALE PRIMARY CARE PRACTICES INC
Practice address
800 Plaza Dr Ste 290
Rostraver Township, PA 15012-4019
Phone
(724) 379-6850
Fax
(678) 553-0330
NPI assigned
Apr 5, 2013
Last updated
Jan 28, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2019

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

Authorized official

Name
Daniel Simmons
Title
Secretaty/Treasurer
Phone
(724) 258-1106

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

800 Plaza Dr Ste 290
Rostraver Township, PA 15012-4019

Mailing address

1163 Country Club Road
Monongahela, PA 15063
Phone (724) 258-1106

Other practice location 1

371 Skyline Dr
California, PA 15419-1278
Phone (724) 379-6850

Other practice location 2

447 W Main St
Monongahela, PA 15063-2564
Phone (724) 258-2070

Other practice location 3

6108 Brownsville Road Ext
Suite 204
Finleyville, PA 15332-4132
Phone (724) 782-0723

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130824000072 PA Part B Supplier - Clinic/Group Practice 4880837772 Receives reassigned benefits from 17 practitioners
Practice locations: California, PA; Finleyville, PA; Monongahela, PA; Rostraver Township, PA; Rostraver TWP, PA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0175531Mon-Vale Primary Care, Inc447 West Main Street, Monongahela, PA 15063Provider-performed microscopyJul 17, 2028
39D2064056Mon Vale Primary Care Physicians6108 Brownsville Road Ext Suite 204, Finleyville, PA 15332Certificate of waiverAug 13, 2027

National Provider Directory

National Provider Directory

Locations

130 Woodland Ct
Brownsville, PA 15417
Phone (724) 330-5290

100 Stoops Dr
Ste 280
Monongahela, PA 15063
Phone (724) 483-4263

800 Plaza Dr
Ste 290
Rostraver Township, PA 15012
Phone (724) 379-6850

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1365120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548633600000",
    "number": "1669715843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1163 COUNTRY CLUB ROAD",
            "city": "MONONGAHELA",
            "state": "PA",
            "postal_code": "15063",
            "telephone_number": "724-258-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PLAZA DR STE 290",
            "city": "ROSTRAVER TOWNSHIP",
            "state": "PA",
            "postal_code": "150124019",
            "telephone_number": "724-379-6850",
            "fax_number": "678-553-0330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "371 Skyline Dr",
            "address_purpose": "LOCATION",
            "city": "California",
            "state": "PA",
            "postal_code": "154191278",
            "country_code": "US",
            "telephone_number": "724-379-6850",
            "fax_number": "678-553-0330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "447 W Main St",
            "address_purpose": "LOCATION",
            "city": "Monongahela",
            "state": "PA",
            "postal_code": "150632564",
            "country_code": "US",
            "telephone_number": "724-258-2070",
            "fax_number": "855-475-6063",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6108 Brownsville Road Ext",
            "address_2": "Suite 204",
            "address_purpose": "LOCATION",
            "city": "Finleyville",
            "state": "PA",
            "postal_code": "153324132",
            "country_code": "US",
            "telephone_number": "724-782-0723",
            "fax_number": "724-782-0728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MON-VALE PRIMARY CARE PRACTICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-05",
        "last_updated": "2019-01-28",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "SECRETATY/TREASURER",
        "authorized_official_telephone_number": "724-258-1106"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rostraver Township, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.