Individual provider Active NPI

Justin David McCrory, DO

  • Emergency Medicine Physician
  • Meadville, PA
National Provider Identifier
1699417691
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS023410 Issued in PA
Practice address
751 Liberty St
Meadville, PA 16335-2559
Phone
(814) 333-5000
NPI assigned
Apr 11, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X OS023410 PA Primary

Addresses

Primary practice location

751 Liberty St
Meadville, PA 16335-2559

Mailing address

3600 Forbes Ave Ste 140
Pittsburgh, PA 15213-3410
Phone (412) 647-6340

Other practice location 1

201 State St
Erie, PA 16550-0002
Phone (814) 877-2594

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
I20250611003360 PA Practitioner - Emergency Medicine 1456735414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meadville Medical CenterGroup PAC ID 4284535790, 139 clinicians

Practice addresses (Care Compare)

751 Liberty St
Meadville, PA 16335-2559
Phone (814) 333-5081

Hospital & facility affiliations

  • Meadville Medical Center Hospital, Meadville, PA, CCN 390113

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS023410PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meadville Medical Center CurrentSince Jul 1, 2025 Accepting new patients
Meadville Medical Center Emergency Medicine CurrentSince Jul 1, 2025 Accepting new patients
Meadville Clinical Pathologists, Inc Current Accepting new patients

Locations

751 Liberty St
Meadville, PA 16335
Phone (814) 333-5081

1034 Grove St
Meadville, PA 16335
Phone (814) 333-5728

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1699417691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 FORBES AVE STE 140",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152133410",
            "telephone_number": "412-647-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 LIBERTY ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352559",
            "telephone_number": "814-333-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 State St",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165500002",
            "country_code": "US",
            "telephone_number": "814-877-2594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCRORY",
        "first_name": "JUSTIN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-11",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS023410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meadville, PA

Sources for this page

Verify at the official NPI Registry.