Individual provider Active NPI

Paulo Renato Correa, M.D.

  • Psychiatry Physician
  • Danville, PA
National Provider Identifier
1780866152
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD468609 Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822
Phone
(570) 271-6516
Fax
(570) 271-5814
NPI assigned
Nov 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 045578 CT
Geriatric Psychiatry Physician 2084P0805X 045578 CT
Psychiatry Physician 2084P0800X MD468609 PA Primary

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (702) 716-1445

Other practice location 1

1450 Chapel St
New Haven, CT 06511-4405
Phone (203) 789-3239

Other practice location 2

1450 Chapel St
New Haven, CT 06511-4405
Phone (203) 789-3239

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pcorrea229134@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD468609PAMDPsychiatry Physician
045578CTMDGeriatric Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bristol Hospital Multi-Specialty Group, Inc. Psychiatry Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1780866152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "702-716-1445",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "17822",
            "telephone_number": "570-271-6516",
            "fax_number": "570-271-5814"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1450 Chapel St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065114405",
            "country_code": "US",
            "telephone_number": "203-789-3239",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1450 Chapel St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065114405",
            "country_code": "US",
            "telephone_number": "203-789-3239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORREA",
        "first_name": "PAULO",
        "middle_name": "RENATO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-28",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "045578",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "CT",
            "license": "045578",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD468609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcorrea229134@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 N Academy Ave",
            "city": "Danville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "17822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.