Individual provider Active NPI

Gerald M Streets, M.D.

  • Psychiatry Physician
  • Clarion, PA
National Provider Identifier
1679786669
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD040275E Issued in PA
Practice address
22868 Route 68 Ste 5
Clarion, PA 16214-8566
Phone
(814) 227-2941
Fax
(814) 227-2946
NPI assigned
May 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD040275E PA Primary

Addresses

Primary practice location

22868 Route 68 Ste 5
Clarion, PA 16214-8566

Mailing address

22868 Route 68 Ste 5
Clarion, PA 16214-8566
Phone (814) 227-2941

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
I20070628000474 PA Practitioner - Psychiatry 5395844559 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD040275EPAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Philhaven Past Accepting new patients
Family Therapy Services Inc. PastSince Oct 9, 2022 Accepting new patients
Livewell Chiropractic of Sarver, PC Past Accepting new patients

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1679786669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22868 ROUTE 68 STE 5",
            "city": "CLARION",
            "state": "PA",
            "postal_code": "162148566",
            "telephone_number": "814-227-2941",
            "fax_number": "814-227-2946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22868 ROUTE 68 STE 5",
            "city": "CLARION",
            "state": "PA",
            "postal_code": "162148566",
            "telephone_number": "814-227-2941",
            "fax_number": "814-227-2946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREETS",
        "first_name": "GERALD",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2023-03-07",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD040275E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarion, PA

Sources for this page

Verify at the official NPI Registry.