NPIMap

Organization Active NPI

Millcreek Community Hospital

Doing business as LECOM Health West Grandview Primary Care

  • Family Medicine Physician
  • Erie, PA
National Provider Identifier
1851287288
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MILLCREEK COMMUNITY HOSPITAL
Doing business as
LECOM Health West Grandview Primary Care
Practice address
2000 W Grandview Blvd
Erie, PA 16509-1029
Phone
(814) 868-1088
Fax
(814) 868-1094
NPI assigned
Jun 13, 2025
Last updated
Jul 14, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
MILLCREEK COMMUNITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Authorized official

Name
Jean Nejman
Title
Credentialing Specialist
Phone
(814) 868-2507

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Foot & Ankle Surgery Podiatrist 213ES0103X

Addresses

Primary practice location

2000 W Grandview Blvd
Erie, PA 16509-1029

Mailing address

5515 Peach St
Erie, PA 16509-2603
Phone (814) 864-4031

Other names 1

  • LECOM Health West Grandview Primary Care Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20091028000324 PA Part A Provider - Hospital 8426020173 8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Erie, PA; Waterford, PA; Albion, PA
O20250626000572 PA Part B Supplier - Hospital Department(S) 8426020173 Receives reassigned benefits from 2 practitioners
Practice locations: Erie, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851287288. Details of each certification follow.

Hospital certification: CCN 390198

Legal name
MILLCREEK COMMUNITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Nov 20, 2017
Beds
144 (138 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
May 20, 1948 in PA
Enrollment address
5515 Peach St
Erie, PA 16509-2603
Other Hospital Practice Location
Hospital subgroups
General, Acute care

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

Other NPIs with the same Medicare PAC ID 23

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

View all 23

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Lecom Medical Center and Behavioral Health PavCCN 390198 · All quality measures
Overall star rating
1 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Eastside Medical Center34 organizations share this tax ID, including this one
Part of
Eastside Medical Center

Other organizations with this tax ID 33

Organizations that report the same tax identification number in the National Provider Directory.

View all 33

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
John M Ferretti Individual Corporate DirectorBoard Member Aug 1, 2017
William F McCarthy Individual Corporate DirectorBoard Member Jul 1, 1966
Seth Hintze Carter Individual Corporate DirectorBoard Member Jan 1, 2025
Silvia M Ferretti Individual Corporate DirectorBoard Secretary Jul 1, 1966
James Yi Lin Individual Corporate DirectorBoard Member Jan 1, 2025
Marcus Babiak Individual W-2 Managing EmployeeCoo Jan 22, 2025
Danielle Marie Hansen Individual Corporate DirectorBoard Member Jan 1, 2021
Steven Inman Individual Corporate DirectorCeo Dec 31, 2018
Robert George Individual Corporate DirectorBoard Member May 9, 2020
David Rubino Individual Corporate DirectorBoard Member Aug 1, 2017
Mary L Eckert Individual Corporate DirectorBoard President Jul 1, 1966
Nancy Z Oneill Individual Corporate DirectorBoard Member Jul 1, 1966
Dale P Sparber Individual Corporate DirectorBoard Member Jul 1, 1966

Owners & managing parties with NPI records 4

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

Practitioners & affiliated clinicians

Practitioners 2

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.

Affiliated clinicians 117

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

View all 117

NPI Registry JSON

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

{
    "created_epoch": "1749772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752451200000",
    "number": "1851287288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5515 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092603",
            "telephone_number": "814-864-4031",
            "fax_number": "814-868-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W GRANDVIEW BLVD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165091029",
            "telephone_number": "814-868-1088",
            "fax_number": "814-868-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLCREEK COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MILLCREEK COMMUNITY HOSPITAL",
        "enumeration_date": "2025-06-13",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A",
        "authorized_official_last_name": "NEJMAN",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "814-868-2507"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LECOM Health West Grandview Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LECOM Health West Grandview Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.