NPIMap

Organization Active NPI

Medical Associates of Erie

Doing business as Plaza 18 Behavioral Health

  • Child & Adolescent Psychiatry Physician
  • Erie, PA
National Provider Identifier
1861025058
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
MEDICAL ASSOCIATES OF ERIE
Doing business as
Plaza 18 Behavioral Health
Practice address
537 W 18TH St
Erie, PA 16502-1722
Phone
(814) 456-1009
Fax
(814) 454-6051
NPI assigned
Feb 17, 2020
Organization subpart
Yes
Parent organization
MEDICAL ASSOCIATES OF ERIEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 17, 2020

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

Authorized official

Name
Nicole Grossi
Title
Credentialing Specialist
Phone
(814) 868-2507

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X Primary

Addresses

Primary practice location

537 W 18TH St
Erie, PA 16502-1722

Mailing address

1 Lecom PL
Erie, PA 16505-2571
Phone (814) 868-2507

Other identifiers 1

IdentifierTypeStateIssuer
1010664580029MedicaidPA

Other names 1

  • Plaza 18 Behavioral Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Eastside Medical Center36 organizations share this tax ID, including this one
Part of
Eastside Medical Center

Other organizations with this tax ID 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1581897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581897600000",
    "number": "1861025058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LECOM PL",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165052571",
            "telephone_number": "814-868-2507",
            "fax_number": "814-868-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 W 18TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165021722",
            "telephone_number": "814-456-1009",
            "fax_number": "814-454-6051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES OF ERIE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDICAL ASSOCIATES OF ERIE",
        "enumeration_date": "2020-02-17",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A",
        "authorized_official_last_name": "GROSSI",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "814-868-2507"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010664580029",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plaza 18 Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; 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.