NPIMap

Organization Active NPI

Mainline Medical Associates Inc

  • Family Medicine Physician
  • Altoona, PA
National Provider Identifier
1790796100
Registry record updated Oct 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MAINLINE MEDICAL ASSOCIATES INC
Practice address
1400 9TH Ave
Altoona, PA 16602-2415
Phone
(814) 941-8811
Fax
(814) 941-8828
NPI assigned
Aug 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2012

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

Authorized official

Name
Val Mignogna
Title
Practice Manager
Phone
(814) 941-8811

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary
Clinical Medical Laboratory 291U00000X 010099A PA

Addresses

Primary practice location

1400 9TH Ave
Altoona, PA 16602-2415

Mailing address

792 Gallitzin Rd
Cresson, PA 16630-2213
Phone (814) 886-8161

Other identifiers 3

IdentifierTypeStateIssuer
001746002MedicaidPA
056175OtherPAHIGHMARK GROUP PROVIDER #
056175OtherPAMEDICARE ID - TYPE UNSPECIFIED PT GROUP #

National Provider Directory

National Provider Directory

Locations

794 Gallitzin Rd
Cresson, PA 16630
Phone (814) 886-5097

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351209600000",
    "number": "1790796100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "792 GALLITZIN RD",
            "city": "CRESSON",
            "state": "PA",
            "postal_code": "166302213",
            "telephone_number": "814-886-8161",
            "fax_number": "814-886-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 9TH AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166022415",
            "telephone_number": "814-941-8811",
            "fax_number": "814-941-8828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINLINE MEDICAL ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2012-10-26",
        "status": "A",
        "authorized_official_last_name": "MIGNOGNA",
        "authorized_official_first_name": "VAL",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "814-941-8811"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PA",
            "license": "010099A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001746002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK GROUP PROVIDER #",
            "identifier": "056175",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID - TYPE UNSPECIFIED  PT GROUP #",
            "identifier": "056175",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; 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.