Organization Active NPI

Mount Nittany Health Ventures

  • Ambulatory Surgical Clinic/Center
  • State College, PA
National Provider Identifier
1689439283
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
MOUNT NITTANY HEALTH VENTURES
Practice address
164 Greenview Drive
State College, PA 16803
Phone
(814) 231-7000
Fax
(814) 238-0790
NPI assigned
Feb 14, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Authorized official

Name
Mr. Bryan J Roach
Title
Cfo
Phone
(814) 234-6148

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary
Endoscopy Clinic/Center 261QE0800X

Addresses

Primary practice location

164 Greenview Drive
State College, PA 16803

Mailing address

155 Wellness Way
State College, PA 16803-6702
Phone (814) 231-7000

Other names 1

  • Mount Nittany Health Outpatient Endoscopy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250610003800 PA Part B Supplier - Ambulatory Surgical Center 9739699521 Practice locations: State College, 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
39D2306204Mt Nittany HLTH Op Endoscopy164 Greenview Drive, State College, PA 16803ComplianceJan 12, 2028

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1707868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773187200000",
    "number": "1689439283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 WELLNESS WAY",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036702",
            "telephone_number": "814-231-7000",
            "fax_number": "814-238-0790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 GREENVIEW DRIVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "16803",
            "telephone_number": "814-231-7000",
            "fax_number": "814-238-0790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT NITTANY HEALTH VENTURES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-14",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A",
        "authorized_official_last_name": "ROACH",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "814-234-6148",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mount Nittany Health Outpatient Endoscopy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mount Nittany Health Outpatient Endoscopy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; 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.