NPIMap

Individual provider Active NPI

Michael Wellington Faulk, MD

  • Emergency Medicine Physician
  • Warren, PA
National Provider Identifier
1780899567
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD432033 Issued in PA
Practice address
2 Crescent Park West
Warren, PA 16365-2111
Phone
(814) 723-2510
Fax
(814) 723-4654
NPI assigned
May 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD432033 PA Primary

Addresses

Primary practice location

2 Crescent Park West
Warren, PA 16365-2111

Mailing address

2 Crescent Park West
Warren, PA 16365-2111
Phone (814) 723-2510

Other identifiers 4

IdentifierTypeStateIssuer
000000543098OtherOHANTHEM
N424355OtherOHNON PAR WELLCARE
2770014MedicaidOH
1019333580004MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070725000411 PA Practitioner - Emergency Medicine 7113028820 Reassigns benefits to 2 organizations
I20130828000057 NY Practitioner - Emergency Medicine 7113028820 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ahn Emergency Group of Erie County LTDGroup PAC ID 3072746585, 6 clinicians
Great Lakes Physician Practice PCGroup PAC ID 6709007701, 143 clinicians

Practice addresses (Care Compare)

189 E Main St
Westfield, NY 14787-1104
Phone (716) 326-4921

207 Foote Ave
Jamestown, NY 14701-7077
Phone (716) 934-3641

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.54 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

Merit-based Incentive Payment System (MIPS)

Final score
83.74 of 100Reported as group
Quality
78.36
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD432033PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellnow Urgent Care, PC CurrentSince Oct 20, 2018 Accepting new patients
Great Lakes Physician Practice PC Emergency Medicine CurrentSince Apr 1, 2025 Accepting new patients
Ahn Emergency Group of Erie County LTD. Emergency Medicine CurrentSince Aug 30, 2018 Accepting new patients
Jamestown Area Medical Associates, L.L.P. CurrentSince Jun 1, 1997 Accepting new patients
Emergency Physician Services of New York, P.C. Emergency Medicine Past Accepting new patients
Brown Memorial Hospital Emergency Medicine Past Accepting new patients
4M Emergency Systems Andover LLC Emergency Medicine Past Accepting new patients
4M Emergency Systems LLC Emergency Medicine Past Accepting new patients

Locations

446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496

207 Foote Ave
Jamestown, NY 14701
Phone (716) 487-0141

31 Sherman St
Ste 2400
Jamestown, NY 14701
Phone (814) 483-5306

7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064

189 E Main St
Westfield, NY 14787
Phone (716) 326-4921

2 Hot Metal St
Bldg 3RD
Pittsburgh, PA 15203

2 W Crescent Park
Warren, PA 16365
Phone (814) 452-5337

Interoperability endpoints

  • Direct secure messaging: michaelfaulk@chqgovdoh.medentdirect.com

Organizations & group practices 9

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369094400000",
    "number": "1780899567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CRESCENT PARK WEST",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163652111",
            "telephone_number": "814-723-2510",
            "fax_number": "814-723-4654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CRESCENT PARK WEST",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163652111",
            "telephone_number": "814-723-2510",
            "fax_number": "814-723-4654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULK",
        "first_name": "MICHAEL",
        "middle_name": "WELLINGTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2013-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD432033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000543098",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NON PAR WELLCARE",
            "identifier": "N424355",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2770014",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019333580004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, PA

Sources for this page

Verify at the official NPI Registry.