NPIMap

Organization Active NPI

Bucktail Medical Center

  • Critical Access Hospital
  • Renovo, PA
National Provider Identifier
1821083700
Registry record updated Aug 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
549601 Issued in PA
Legal business name
BUCKTAIL MEDICAL CENTER
Practice address
1001 Pine St
Renovo, PA 17764-1618
Phone
(570) 923-1000
Fax
(570) 923-1812
NPI assigned
Sep 15, 2005
Last updated
Aug 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2026

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

Authorized official

Name
Laura Murnyack
Title
Ceo
Phone
(570) 531-6299

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Critical Access Hospital Clinic/Center 261QC0050X
Critical Access Hospital 282NC0060X 549601 PA Primary

Addresses

Primary practice location

1001 Pine St
Renovo, PA 17764-1618

Mailing address

1001 Pine St
Renovo, PA 17764-1618
Phone (570) 923-1000

Other identifiers 4

IdentifierTypeStateIssuer
1007644390004MedicaidPA
1007644390007MedicaidPA
1007644390002MedicaidPA
1007644390003MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041208000866 PA Part B Supplier - Clinic/Group Practice 6800852112 Receives reassigned benefits from 9 practitioners
Practice locations: Renovo, PA
O20110307000465 PA Part A Provider - Critical Access Hospital 6800852112 Receives reassigned benefits from 23 practitioners
Practice locations: Renovo, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821083700. Details of each certification follow.

Hospital certification: CCN 391304

Legal name
BUCKTAIL MEDICAL CENTER
Doing business as
EQUALIZERCM SERVICES
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Sep 1, 2001
Last certification
Dec 11, 2025
Beds
16
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jul 19, 1909 in PA
Enrollment address
1001 Pine St
Renovo, PA 17764-1618

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Bucktail Medical CenterCCN 391304 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
John K Lugg Individual 5% Or Greater Direct Ownership InterestGeneral Board Member Mar 30, 2020 8.3%
Corporate DirectorGeneral Board Member Mar 30, 2020
Martha Sykes Individual 5% Or Greater Direct Ownership InterestBoard Member Feb 1, 2010 8.3%
Corporate OfficerSecretary/Treasurer Jun 28, 2017 8.3%
Corporate DirectorBoard Member Feb 1, 2010 8.3%
Richard Grenell Individual 5% Or Greater Direct Ownership InterestGeneral Member Board of Directors Apr 7, 2025 8.3%
Corporate OfficerGeneral Member Board of Directors Apr 7, 2025 8.3%
James K Tarantella Individual 5% Or Greater Direct Ownership InterestGeneral Member Board of Directors Apr 7, 2025 8.3%
Corporate OfficerVice President Jul 1, 2025 8.3%
Tracy E Bruno Individual 5% Or Greater Direct Ownership InterestBoard Member Jul 1, 2020 8.3%
Corporate DirectorBoard Member Jul 1, 2020 8.3%
Toni Marcheskie Individual Contracted Managing EmployeeMD; Feb 1, 2024 25%
Corporate DirectorMedical Director, Board of Director Feb 1, 2024 8.3%
Ann Sanford Individual 5% Or Greater Direct Ownership InterestGeneral Member Board of Directors Apr 7, 2025 8.3%
Corporate OfficerGeneral Member Board of Directors Apr 7, 2025 8.3%
Laura Murnyack Individual W-2 Managing EmployeeChief Executive Officer Dec 15, 2024 25%
Keith H Wilson Individual 5% Or Greater Direct Ownership InterestGeneral Member Board of Directors Apr 7, 2025 8.3%
Corporate OfficerGeneral Member Board of Directors Apr 7, 2025 8.3%
Steven H Rathmell Individual 5% Or Greater Direct Ownership InterestGeneral Member Board of Directors Apr 7, 2025 8.3%
Corporate OfficerGeneral Member Board of Directors Apr 27, 2025 8.3%
Aimee Lynn Individual W-2 Managing EmployeeDirector of Clinical Services Mar 1, 2025 25%
Operational/Managerial ControlDirector of Clinical Services Mar 1, 2025 25%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

Affiliated clinicians 14

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786060800000",
    "number": "1821083700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 PINE ST",
            "city": "RENOVO",
            "state": "PA",
            "postal_code": "177641618",
            "telephone_number": "570-923-1000",
            "fax_number": "570-923-1812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 PINE ST",
            "city": "RENOVO",
            "state": "PA",
            "postal_code": "177641618",
            "telephone_number": "570-923-1000",
            "fax_number": "570-923-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKTAIL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-15",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A",
        "authorized_official_last_name": "MURNYACK",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "570-531-6299"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Critical Access Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "PA",
            "license": "549601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007644390004",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007644390007",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007644390002",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007644390003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Renovo, PA

Sources for this page

Verify at the official NPI Registry.