North Columbia Medical Offices, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NORTH COLUMBIA MEDICAL OFFICES, INC.

Practice address

4469 Red Rock Rd
Benton, PA 17814-7606

Phone

(570) 925-6424

Fax

(570) 925-5930

NPI assigned

Apr 4, 2006

Last updated

Aug 22, 2020By 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

Dr. Richard A Prisuta, D.O.NPI 1669468997

Title

President

Phone

(570) 925-6424

Specialties & licenses 1

Addresses

Other identifiers 5

Practitioners 1

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.

• Richard A Prisuta, D.O.

  • Family Medicine Physician
  • Benton, PA
  • NPI 1669468997
  NPD (past) Authorized official

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720040090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 390",
            "city": "BENTON",
            "state": "PA",
            "postal_code": "178140390",
            "telephone_number": "570-925-6424",
            "fax_number": "570-925-5930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4469 RED ROCK RD",
            "city": "BENTON",
            "state": "PA",
            "postal_code": "178147606",
            "telephone_number": "570-925-6424",
            "fax_number": "570-925-5930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COLUMBIA MEDICAL OFFICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRISUTA",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-925-6424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007396970001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "506030",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "M2378",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02283200",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PLAN",
            "identifier": "C325",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurie Jeannette Kerschner, CRNP
• Shelby L Kester, LPN
• Thomas Anthony Kowalski, DDS
• Charlotte K Moss, RPH
• Dale Neiderhiser, D.C.
• Richard A Prisuta, D.O.
• Ekatherina Shaportova
• Sugarloaf Community Rescue &
• Sugarloaf Community Rescue & Ambulance Association
• Vine Pharmacy

• Family Medicine Physician in Benton, PA
• Providers in Benton, 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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.