Individual provider Active NPI

Joseph F. Tavares, M.D.

  • Family Medicine Physician
  • Johnstown, PA
National Provider Identifier
1790850097
Registry record updated Oct 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD032484E Issued in PA
Practice address
322 Warren St
Suite 300
Johnstown, PA 15905-3443
Phone
(814) 288-4498
Fax
(814) 288-5427
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD032484E PA Primary

Addresses

Primary practice location

322 Warren St
Suite 300
Johnstown, PA 15905-3443

Mailing address

322 Warren St
Suite 300
Johnstown, PA 15905-3443
Phone (814) 288-4498

Other identifiers 1

IdentifierTypeStateIssuer
1147517-05MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180125001857 PA Practitioner - Family PracticePractitioner - Pathology 6204938079 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centerville Clinics, Inc. Current Accepting new patients
Centerville Clinics, Inc CurrentSince Apr 23, 2018 Accepting new patients
Centerville Clinics, Inc. Family Medicine CurrentSince Apr 23, 2018 Accepting new patients
Centerville Clinics, Inc. Current Accepting new patients
Centerville Clinics, Inc. Current Accepting new patients
Centerville Clinics, Inc. Current Accepting new patients
Pain Resolution, P.C. Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

1070 Old National Pike
Fredericktown, PA 15333

86 McClellandtown Rd
Uniontown, PA 15401
Phone (724) 430-7990

Interoperability endpoints

  • Direct secure messaging: jtavares83440@direct-lghealth.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382572800000",
    "number": "1790850097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 WARREN ST",
            "address_2": "SUITE 300",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159053443",
            "telephone_number": "814-288-4498",
            "fax_number": "814-288-5427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 WARREN ST",
            "address_2": "SUITE 300",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159053443",
            "telephone_number": "814-288-4498",
            "fax_number": "814-288-5427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVARES",
        "first_name": "JOSEPH",
        "middle_name": "F.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2013-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD032484E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1147517-05",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.