Heritage Valley Medical Group, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

020430 Issued in PA

Legal business name

HERITAGE VALLEY MEDICAL GROUP, INC.

Practice address

1200 Sharon Rd
Suite 200
Beaver, PA 15009-3148

Phone

(724) 774-5030

Fax

(724) 774-5040

NPI assigned

Jan 8, 2008

Last updated

May 14, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Norman F. Mitry

Title

President and Ceo

Phone

(724) 773-4776

Specialties & licenses 1

Addresses

Other names 1

• Tri State Medical Group, Inc. Former legal business name

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

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

• Heritage Valley Multispecialty Group, Inc.

  • Internal Medicine Physician
  • Beaver, PA
  • NPI 1528015401

  O20040804001937

  Same enrollment
• Heritage Valley Multispecialty Group, Inc.

  dba Heritage Valley Convenient Care

  • Urgent Care Clinic/Center
  • Beaver Falls, PA
  • NPI 1700013976

  O20040804001937

  Same enrollment

Locations

Practitioners 1

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.

• Corrine Lyn Anderson, PA-C

  • Physician Assistant
  • New Castle, PA
  • NPI 1679688287
  NPD

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336953600000",
    "number": "1952586927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PEARTREE WAY",
            "address_2": "TRI-STATE MEDICAL GROUP INC",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "15009",
            "telephone_number": "724-728-4171",
            "fax_number": "724-728-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SHARON RD",
            "address_2": "SUITE 200",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "150093148",
            "telephone_number": "724-774-5030",
            "fax_number": "724-774-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE VALLEY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-08",
        "last_updated": "2012-05-14",
        "status": "A",
        "authorized_official_last_name": "MITRY",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "724-773-4776"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PA",
            "license": "020430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tri State Medical Group, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Heritage Valley Medical Group, Inc. (HVMG Surgical Associates - Robert Meuser, MD)
• Heritage Valley Medical Group, Inc. (HVMNG Beaver Internal Medicine Associates)
• Heritage Valley Medical Group, Inc. (HVMG Associates of Internal Medicine)
• Heritage Valley Medical Group, Inc. (HVMG Valley Internal Medicine)
• Heritage Valley Medical Group, Inc. (HVMG Cardiothoracic & Vascular Surgery)
• Heritage Valley Medical Group, Inc. (HVMG Mouhannad Azzouz, MD)
• Heritage Valley Multispecialty Group, Inc
• Heritage Valley Multispecialty Group, Inc.
• Heritage Valley Radiology, Inc.
• Heritage Valleymedical Group, Inc. (HVMG Les T. Pallone D.O.)

• Clinical Medical Laboratory in Beaver, PA
• Providers in Beaver, PA by specialty
• Clinical Medical Laboratory in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2012; 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.