Organization Active NPI

Keystone Family Medicine Associates, P. C.

  • Family Medicine Physician
  • Mount Carmel, PA
National Provider Identifier
1902859101
Registry record updated Nov 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS-005323-L Issued in PA
Legal business name
KEYSTONE FAMILY MEDICINE ASSOCIATES, P. C.
Practice address
28 E 5TH St
Mount Carmel, PA 17851-2106
Phone
(570) 339-5754
Fax
(570) 339-3820
NPI assigned
May 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2015

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

Authorized official

Name
Dr. Raymond J Kraynak, D.O.
Title
President
Phone
(570) 339-5754

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OS-005323-L PA Primary

Addresses

Primary practice location

28 E 5TH St
Mount Carmel, PA 17851-2106

Mailing address

28 E 5TH St
Mount Carmel, PA 17851-2106
Phone (570) 339-5754

Other identifiers 1

IdentifierTypeStateIssuer
0016251410001MedicaidPA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447286400000",
    "number": "1902859101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 E 5TH ST",
            "city": "MOUNT CARMEL",
            "state": "PA",
            "postal_code": "178512106",
            "telephone_number": "570-339-5754",
            "fax_number": "570-339-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 E 5TH ST",
            "city": "MOUNT CARMEL",
            "state": "PA",
            "postal_code": "178512106",
            "telephone_number": "570-339-5754",
            "fax_number": "570-339-3820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE FAMILY MEDICINE ASSOCIATES, P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2015-11-12",
        "status": "A",
        "authorized_official_last_name": "KRAYNAK",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-339-5754",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS-005323-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016251410001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Carmel, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; 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.