NPIMap

Organization Active NPI

Monongahela Valley Hospital Inc

  • Certified Registered Nurse Anesthetist
  • Monongahela, PA
National Provider Identifier
1689708570
Registry record updated Feb 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
MONONGAHELA VALLEY HOSPITAL INC
Practice address
1163 Country Club Road
Monongahela, PA 15063-1095
Phone
(724) 258-1000
Fax
(724) 258-1394
NPI assigned
Mar 15, 2007
Last updated
Feb 3, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2015

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

Authorized official

Name
Mr. Lawrence J Rusnock
Title
VP/Controller
Phone
(724) 258-1160

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X Primary

Addresses

Primary practice location

1163 Country Club Road
Monongahela, PA 15063-1095

Mailing address

1163 Country Club Road
Monongahela, PA 15063-1095
Phone (724) 258-1000

Other identifiers 1

IdentifierTypeStateIssuer
CD4650OtherGAPALMETTO GBA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040301000802 PA Part B Supplier - Clinic/Group Practice 0143117606 Receives reassigned benefits from 56 practitioners
6 other NPIs on this enrollment
Practice locations: Connellsville, PA; Rostraver TWP, PA; Monongahela, PA

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 59

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 59

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422921600000",
    "number": "1689708570",
    "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": "150631095",
            "telephone_number": "724-258-1000",
            "fax_number": "724-258-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1163 COUNTRY CLUB ROAD",
            "city": "MONONGAHELA",
            "state": "PA",
            "postal_code": "150631095",
            "telephone_number": "724-258-1000",
            "fax_number": "724-258-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONONGAHELA VALLEY HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2015-02-03",
        "status": "A",
        "authorized_official_last_name": "RUSNOCK",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VP/CONTROLLER",
        "authorized_official_telephone_number": "724-258-1160",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "CD4650",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monongahela, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; 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.