Alvaro N Changco, MD
Individual provider Active NPI Family Medicine Physician · Cokeburg, PA
NPI 1922009240 · NPPES record last updated Jan 22, 2008
Key facts
- NPI
- 1922009240
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD035890L (PA)
- Practice address
- 14 Route 917
Cokeburg, PA 15324 - Phone
- (724) 945-6128
- Fax
- (724) 945-6252
- NPI assigned
- Aug 9, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 28
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1963
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Centerville Clinics, Inc.
Practice addresses (Care Compare)
1070 Old National PK Rd
Internal Medicine
Fredericktown, PA 15333-2114
Phone (724) 632-6801
Hospital & facility affiliations
- Amedisys Home Health of PA
- Concordia Visiting Nurses
- Ospta at Home
- Washington Hospital, the
- Penn Highlands Mon Valley
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070509000396 | PA | Practitioner - Family Practice | 3779689617 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD035890L | PA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centerville Clinics, Inc. | Current | Accepting new patients | |
| Centerville Clinics, Inc. | Current | Accepting new patients | |
| Centerville Clinics, Inc. | Current | Accepting new patients | |
| Centerville Clinics, Inc | Current |
Accepting new patients | |
| Centerville Clinics, Inc. | Family Medicine | Current |
Accepting new patients |
| Centerville Clinics, Inc. | Current | Accepting new patients | |
| Centerville Clinics, Inc. | Past | Accepting new patients |
Locations
1070 Old National Pike
Fredericktown, PA 15333
Interoperability endpoints
- alvaro.changco.1@33484.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD035890L | PA | Yes |
Addresses
Primary practice location
14 Route 917
Cokeburg, PA 15324
Mailing address
PO Box 232
Cokeburg, PA 15324-0232
Phone (724) 945-6128
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000723470 | Medicaid | PA | |
| 176649 | Other | PA | HIGHMARK BLUE SHIELD |
Other providers in Cokeburg, PA
All providers in Cokeburg, PA · Family Medicine 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 Jan 22, 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.