Organization Active NPI

State College Urologic Associates, Inc.

  • Urology Physician
  • State College, PA
National Provider Identifier
1780631564
Registry record updated Aug 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
STATE COLLEGE UROLOGIC ASSOCIATES, INC.
Practice address
905 University Dr
State College, PA 16801-6626
Phone
(814) 238-8418
Fax
(814) 234-2888
NPI assigned
May 27, 2006
Last updated
Aug 2, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2010

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

Authorized official

Name
Ms. Elaine Meyer
Title
Account Coordinator
Phone
(814) 272-3148

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X Primary

Addresses

Primary practice location

905 University Dr
State College, PA 16801-6626

Mailing address

905 University Dr
State College, PA 16801-6626
Phone (814) 238-8418

Other identifiers 1

IdentifierTypeStateIssuer
0006452570001MedicaidPA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280707200000",
    "number": "1780631564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 UNIVERSITY DR",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168016626",
            "telephone_number": "814-238-8418",
            "fax_number": "814-234-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 UNIVERSITY DR",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168016626",
            "telephone_number": "814-238-8418",
            "fax_number": "814-234-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE COLLEGE UROLOGIC ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2010-08-02",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_title_or_position": "ACCOUNT COORDINATOR",
        "authorized_official_telephone_number": "814-272-3148",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006452570001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; 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.