NPIMap

Organization Active NPI

Excela Health Physician Practices, Inc.

Doing business as EH Sports Med/Concussion Mgmt

  • Sports Medicine (Family Medicine) Physician
  • Greensburg, PA
National Provider Identifier
1710142302
Registry record updated May 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
Legal business name
EXCELA HEALTH PHYSICIAN PRACTICES, INC.
Doing business as
EH Sports Med/Concussion Mgmt
Practice address
410 Pellis Rd
Suite 2a
Greensburg, PA 15601-4700
Phone
(724) 689-1070
Fax
(724) 689-1063
NPI assigned
Jul 23, 2008
Last updated
May 7, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
EXCELA HEALTH HOLDING COMPANYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 7, 2020

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

Authorized official

Name
Renee M Varney
Title
Credentialing Coordinator
Phone
(724) 850-6933

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QS0010X Primary

Addresses

Primary practice location

410 Pellis Rd
Suite 2a
Greensburg, PA 15601-4700

Mailing address

134 Industrial Park Rd Ste 1500
Greensburg, PA 15601-8153
Phone (724) 850-6933

Other practice location 1

8775 Norwin Ave
North Huntingdon, PA 15642-2718
Phone (724) 547-1208

Other identifiers 1

IdentifierTypeStateIssuer
0015621860077MedicaidPA

Other names 1

  • EH Sports Med/Concussion Mgmt Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040322001393 PA Part B Supplier - Clinic/Group Practice 6204737117 Receives reassigned benefits from 767 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588809600000",
    "number": "1710142302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 INDUSTRIAL PARK RD STE 1500",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156018153",
            "telephone_number": "724-850-6933",
            "fax_number": "724-522-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 PELLIS RD",
            "address_2": "SUITE 2A",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156014700",
            "telephone_number": "724-689-1070",
            "fax_number": "724-689-1063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8775 Norwin Ave",
            "address_purpose": "LOCATION",
            "city": "North Huntingdon",
            "state": "PA",
            "postal_code": "156422718",
            "country_code": "US",
            "telephone_number": "724-547-1208",
            "fax_number": "724-547-1207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EXCELA HEALTH PHYSICIAN PRACTICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXCELA HEALTH HOLDING COMPANY",
        "enumeration_date": "2008-07-23",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A",
        "authorized_official_last_name": "VARNEY",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "724-850-6933"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015621860077",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EH Sports Med/Concussion Mgmt",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EH Sports Med/Concussion Mgmt",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; 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.