NPIMap

Organization Active NPI

Millcreek Community Hospital

  • Surgery Physician
  • Erie, PA
National Provider Identifier
1871128447
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
MILLCREEK COMMUNITY HOSPITAL
Practice address
5401 Peach St Ste 3600
Erie, PA 16509-2601
Phone
(814) 868-2170
Fax
(814) 868-2108
NPI assigned
Mar 4, 2020
Organization subpart
Yes
Parent organization
MILLCREEK COMMUNITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 13, 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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X

Addresses

Primary practice location

5401 Peach St Ste 3600
Erie, PA 16509-2601

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200616001909 PA Part B Supplier - Hospital Department(S) 8426020173 Receives reassigned benefits from 7 practitioners
Practice locations: Erie, PA

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

National Provider Directory

National Provider Directory
Tax ID family
Millcreek Community Hos34 organizations share this tax ID, including this one
Part of
Millcreek Community Hos

Other organizations with this tax ID 33

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

View all 33

Practitioners & affiliated clinicians

Practitioners 67

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

View all 67

NPI Registry JSON

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749772800000",
    "number": "1871128447",
    "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": "814-868-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 PEACH ST STE 3600",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092601",
            "telephone_number": "814-868-2170",
            "fax_number": "814-868-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLCREEK COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MILLCREEK COMMUNITY HOSPITAL",
        "enumeration_date": "2020-03-04",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "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": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.