Fidelis O Ejianreh, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

BE8240652 Issued in PA

Practice address

2032 E Pleasant Valley Blvd
Altoona, PA 16602

Phone

(814) 684-3101

NPI assigned

Jan 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2016 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Pinecroft Medical Center

  • Family Medicine Physician
  • Altoona, PA
  • NPI 1780622621
  NPD (past)
• Tyrone Medical Associates Specs

  • Orthopaedic Surgery Physician
  • Tyrone, PA
  • NPI 1952344459
  NPD (past)
• Windber Hospital, Inc.

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1699746990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 CRICKLEWOOD DR",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168031899",
            "telephone_number": "814-234-2226",
            "fax_number": "814-234-2258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2032 E PLEASANT VALLEY BLVD",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "16602",
            "telephone_number": "814-684-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EJIANREH",
        "first_name": "FIDELIS",
        "middle_name": "O",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "BE8240652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trista Edwards
• Kaylee Eger, PA-C
• Timothy James Ehgartner, D.M.D.
• Melissa Eilenberger
• Mary L. Eiman, CRNP,MSN
• David Elbert
• Lisa Elder, LMT
• McKenna Mary Grayce Elder
• Elizur Corporation
• Nicole Ellick, CRNP

• Family Medicine Physician in Altoona, PA
• Providers in Altoona, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.