Pine Grove Ambulatory Surgical

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PINE GROVE AMBULATORY SURGICAL

Practice address

10 Timberview Lane
Russell, PA 16345

Phone

(814) 757-5819

Fax

(814) 757-5829

NPI assigned

Sep 19, 2007

Last updated

Feb 19, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Emilee S Langer, MPH

Title

Executive Director

Phone

(814) 688-0426

Specialties & licenses 1

Addresses

Listed as

Pine Grove Ambulatory SurgicalCCN 39C0001258

Medicare certification status

Terminated Voluntary: merger or closure, Feb 19, 2025From the Provider of Services file

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Warren General Hospital

  • Rural Health Clinic/Center
  • Warren, PA
  • NPI 1750104774

  Member Of

  NPD member
• Great Lakes Otolaryngology PC

  • Otolaryngology Physician
  • Olean, NY
  • NPI 1588600522

  Member Of

  NPD member

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1689860124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 TIMBERVIEW LANE",
            "city": "RUSSELL",
            "state": "PA",
            "postal_code": "16345",
            "telephone_number": "814-757-5819",
            "fax_number": "814-757-5829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 TIMBERVIEW LANE",
            "city": "RUSSELL",
            "state": "PA",
            "postal_code": "16345",
            "telephone_number": "814-757-5819",
            "fax_number": "814-757-5829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE GROVE AMBULATORY SURGICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "LANGER",
        "authorized_official_first_name": "EMILEE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "814-688-0426",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dien Viet Le, M.D.
• Margaret Moore
• Ms. Margarets Therapy
• Trevor Michael Olsen, M.D.
• Kathleen Jean Pascatore-Moller, PT
• Tricia Renee Poston, AU.D.
• RC Anesthesia Services LLC
• Kaitlyn Ristau
• Russell Vol Fire Department
• Russell Volunteer Fire Department Inc

• Ambulatory Surgical Clinic/Center in Russell, PA
• Providers in Russell, PA by specialty
• Ambulatory Surgical Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.