NPIMap

Organization Active NPI

Heritage Valley Medical Group, Inc.

  • Family Medicine Physician
  • Midland, PA
National Provider Identifier
1962654475
Registry record updated Jun 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HERITAGE VALLEY MEDICAL GROUP, INC.
Practice address
21 7TH St
Midland, PA 15059-1452
Phone
(724) 643-4852
NPI assigned
Oct 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2012

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

Authorized official

Name
Norman F. Mitry
Title
President & Ceo
Phone
(724) 773-4776

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

21 7TH St
Midland, PA 15059-1452

Mailing address

21 7TH St
Midland, PA 15059-1452
Phone (724) 643-4852

Other identifiers 2

IdentifierTypeStateIssuer
0015654460023MedicaidPA
0202677MedicaidOH

Other names 1

  • HVMG Jay Zdunek, D.O. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Tri - State Medical Group Inc92 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340928000000",
    "number": "1962654475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 7TH ST",
            "city": "MIDLAND",
            "state": "PA",
            "postal_code": "150591452",
            "telephone_number": "724-643-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 7TH ST",
            "city": "MIDLAND",
            "state": "PA",
            "postal_code": "150591452",
            "telephone_number": "724-643-4852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE VALLEY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-15",
        "last_updated": "2012-06-29",
        "status": "A",
        "authorized_official_last_name": "MITRY",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "724-773-4776"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015654460023",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0202677",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HVMG Jay Zdunek, D.O.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Midland, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.