NPIMap

Organization Active NPI

Brookville Hospital

Doing business as Brookville Cardiology Ekg PF

  • Internal Medicine Physician
  • Brookville, PA
National Provider Identifier
1780826438
Registry record updated Aug 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BROOKVILLE HOSPITAL
Doing business as
Brookville Cardiology Ekg PF
Penn Highlands Brookville Cardiology EKG
Practice address
100 Hospital Rd
Brookville, PA 15825
Phone
(814) 849-1842
NPI assigned
Mar 26, 2009
Last updated
Aug 16, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
PENN HIGHLANDS HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 16, 2018

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

Authorized official

Name
Mrs. Tanya L McCandless
Title
Senior Biller
Phone
(814) 849-1842

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary
Cardiovascular Disease Physician 207RC0000X NU
Interventional Cardiology Physician 207RI0011X NU
Cardiology Technician 246W00000X NU

Addresses

Primary practice location

100 Hospital Rd
Brookville, PA 15825

Mailing address

100 Hospital Rd
Brookville, PA 15825-1367
Phone (814) 849-1842

Other identifiers 2

IdentifierTypeStateIssuer
170134OtherMC PTAN
1007733760004MedicaidPA

Other names 2

  • BROOKVILLE CARDIOLOGY EKG PF Doing business as
  • Penn Highlands Brookville Cardiology EKG Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100115000071 PA Part B Supplier - Hospital Department(S) 3072579598 Receives reassigned benefits from 5 practitioners
Practice locations: Brookville, PA

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Brookville Clinic Inc15 organizations share this tax ID, including this one
Part of
Penn Highlands Healthcare

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Penn Highlands Jefferson ManorBrookville, PA, CCN 395626 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 6

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": "1238025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534377600000",
    "number": "1780826438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL RD",
            "city": "BROOKVILLE",
            "state": "PA",
            "postal_code": "158251367",
            "telephone_number": "814-849-1842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL RD",
            "city": "BROOKVILLE",
            "state": "PA",
            "postal_code": "15825",
            "telephone_number": "814-849-1842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKVILLE HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENN HIGHLANDS HEALTHCARE",
        "enumeration_date": "2009-03-26",
        "last_updated": "2018-08-16",
        "status": "A",
        "authorized_official_last_name": "MCCANDLESS",
        "authorized_official_first_name": "TANYA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SENIOR BILLER",
        "authorized_official_telephone_number": "814-849-1842",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "246W00000X",
            "taxonomy_group": "",
            "desc": "Technician, Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC PTAN",
            "identifier": "170134",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007733760004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BROOKVILLE CARDIOLOGY EKG PF",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Penn Highlands Brookville Cardiology EKG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brookville, PA

Sources for this page

Verify at the official NPI Registry.