Centerville Clinics, Inc.
Organization Active NPI Cardiovascular Disease Physician · Fredericktown, PA
NPI 1902887250 · NPPES record last updated Apr 17, 2008
Key facts
- NPI
- 1902887250
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- Legal business name
- CENTERVILLE CLINICS, INC.
- Practice address
- 1070 Old National Pike
Fredericktown, PA 15333-2114 - Phone
- (724) 632-6801
- Fax
- (724) 632-6312
- NPI assigned
- Nov 11, 2005
- Organization subpart
- No
Authorized official
- Name
- Mrs. Patricia Martos
- Title
- Director Personnel/Finance
- Phone
- (724) 632-6801
Other NPIs on the same Medicare enrollment 10
Corporate family (same tax ID) 18
Practitioners 85
-
Susan Elizabeth Albert, CRNP
-
Crystal Lynn Andrews, CRNP
-
Shweta Arora, MD
-
Laila Avetta, MD
-
Alexandria Marie Bakos, CRNP
-
Joshua James Basilone, FNP-C
-
John Reed Beabout Jr., CRNP
-
Robert L Belluso, D.O.
-
Maria R Bening, MD
-
Charles Richard Brown, D.O.
-
Mary Sue Capella, FNP-C
-
Alvaro N Changco, MD
-
Michelle M Cohen, CRNP
-
Marty Cole, MD
-
Amanda G Coltura, CRNP
-
Julie K Derosa, MD
-
Katina Marie Fetsko, CRNP
-
Anita C Fiala, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040427000681 | PA | Part B Supplier - Clinic/Group Practice | 7214837202 |
Receives reassigned benefits from 86 practitioners 10 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bentleyville, PA; Washington, PA; Uniontown, PA; Masontown, PA; Fredericktown, PA; Donora, PA; Connellsville, PA; Charleroi, PA… |
National Provider Directory
- Tax ID family
- Centerville Clinics Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician |
207RC0000X | Yes |
Addresses
Primary practice location
1070 Old National Pike
Fredericktown, PA 15333-2114
Mailing address
1070 Old National Pike
Fredericktown, PA 15333-2114
Phone (724) 632-6801
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 522351 | Other | PA | HIGHMARK |
| 1007288440027 | Medicaid | PA |
Other providers in Fredericktown, PA
- Centerville Clinics, Inc.
- Centerville Clinics, Inc.
- Centerville Clinics, Inc.
- Centerville Clinics, Inc.
- Centerville Clinics, Inc.
- Centerville Clinics, Inc.
- Yong Dae Cho
- Toni Lyn Contestabile
- Cynthia Ellen Cummings
- Cassie Davis
All providers in Fredericktown, PA · Cardiovascular Disease Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.