NPIMap

Organization Active NPI

Tioga Health Care Providers, Inc

Doing business as Susquehanna Health Urology at Soldiers and Sailors Mem Hospital

  • Urology Physician
  • Wellsboro, PA
National Provider Identifier
1932548054
Registry record updated Apr 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
TIOGA HEALTH CARE PROVIDERS, INC
Doing business as
Susquehanna Health Urology at Soldiers and Sailors Mem Hospital
Practice address
15 Meade St
Suite U3
Wellsboro, PA 16901-1813
Phone
(570) 724-3636
Fax
(570) 724-3326
NPI assigned
Jun 21, 2013
Last updated
Apr 1, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
SUSQUEHANA HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 1, 2015

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

Authorized official

Name
Ronald M Gilbert Jr.
Title
Cfo
Phone
(570) 723-0600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X NU Primary

Addresses

Primary practice location

15 Meade St
Suite U3
Wellsboro, PA 16901-1813

Mailing address

22 Walnut St
Wellsboro, PA 16901-1526
Phone (570) 723-0600

Other names 1

  • Susquehanna Health Urology at Soldiers and Sailors Mem Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131024001380 PA Part B Supplier - Clinic/Group Practice 3375597792 Receives reassigned benefits from 18 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wellsboro, PA

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1371772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427846400000",
    "number": "1932548054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 WALNUT ST",
            "city": "WELLSBORO",
            "state": "PA",
            "postal_code": "169011526",
            "telephone_number": "570-723-0600",
            "fax_number": "570-724-2126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MEADE ST",
            "address_2": "SUITE U3",
            "city": "WELLSBORO",
            "state": "PA",
            "postal_code": "169011813",
            "telephone_number": "570-724-3636",
            "fax_number": "570-724-3326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIOGA HEALTH CARE PROVIDERS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUSQUEHANA HEALTH SYSTEM",
        "enumeration_date": "2013-06-21",
        "last_updated": "2015-04-01",
        "status": "A",
        "authorized_official_last_name": "GILBERT",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "570-723-0600",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Susquehanna Health Urology at Soldiers and Sailors Mem Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wellsboro, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2015; 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.