Ty Medovic, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA054473 Issued in PA

Practice address

460 Washington Rd
Suite 7
Washington, PA 15301-2765

Phone

(724) 225-3627

NPI assigned

Sep 7, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV, VA, OH3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wheeling Hospital IncGroup PAC ID 5799689493, 433 clinicians

Wetzel County Hospital IncGroup PAC ID 4284065400, 49 clinicians

Reynolds Memorial Hospital, IncGroup PAC ID 9830184530, 152 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Reynolds Memorial Hospital, Inc Hospital, Glen Dale, WV, CCN 510013
• Wetzel County Hospital Hospital, New Martinsville, WV, CCN 510072

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Reynolds Memorial Hospital, Inc

  • Emergency Medical Services (Emergency Medicine) Physician
  • Glen Dale, WV
  • NPI 1518068014
  Medicare reassignment Care Compare group NPD
• Wetzel County Hospital, Inc.

  • Family Medicine Physician
  • New Martinsville, WV
  • NPI 1518590033
  Medicare reassignment Care Compare group
• Wheeling Hospital Inc

  • Family Medicine Physician
  • Wheeling, WV
  • NPI 1548923923

  OH

  Medicare reassignment Care Compare group
• Medexpress Urgent Care, PC - Virginia

  • Urgent Care Clinic/Center
  • Bluefield, VA
  • NPI 1215219878
  Medicare reassignment
• Urgent Care, Inc.- West Virginia

  • Urgent Care Clinic/Center
  • South Charleston, WV
  • NPI 1912133315
  Medicare reassignment
• Medexpress Urgent Care, PC - Virginia

  • Urgent Care Clinic/Center
  • Richmond, VA
  • NPI 1225563679
  NPD
• Medexpress Urgent Care, PC - Virginia

  • Urgent Care Clinic/Center
  • Franklin, VA
  • NPI 1346763604
  NPD
• Reynolds Memorial Hospital, Inc.

  • Pulmonary Disease Physician
  • Glen Dale, WV
  • NPI 1265040356
  NPD
• Wetzel County Hospital, Inc.

  • Rural Health Clinic/Center
  • Pine Grove, WV
  • NPI 1245846765
  NPD
• Wetzel County Hospital Association

  • Internal Medicine Physician
  • New Martinsville, WV
  • NPI 1699728337
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Reynolds Memorial Hospital, Inc

  • General Acute Care Hospital
  • Glen Dale, WV
  • NPI 1144228305
  Care Compare affiliation
• Wetzel County Hospital, Inc.

  • Rural Acute Care Hospital
  • New Martinsville, WV
  • NPI 1376175240
  Care Compare affiliation

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

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283817600000",
    "number": "1942517412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 WASHINGTON RD",
            "address_2": "SUITE 7",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153012765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 WASHINGTON RD",
            "address_2": "SUITE 7",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153012765",
            "telephone_number": "724-225-3627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDOVIC",
        "first_name": "TY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-07",
        "last_updated": "2010-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA054473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra McQuillan-Dodd, MS, LAPC
• Meadow Dental Services, P.C.
• Medexpress Urgent Care, LLC - Washington
• Medexpress Urgent Care, PC - Pennsylvania
• Medexpress Urgent Care, PC - Virginia
• Alexis M Megaludis, M.D.
• Shalima Mehta
• Holliann M Meighen, CRNA
• Amanda Melocchi
• Emily Marie Meyers, PA-C

• Medical Physician Assistant in Washington, PA
• Providers in Washington, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.