Individual provider Active NPI

Anthony B Rentz, PA-C

  • Surgical Physician Assistant
  • Johnstown, PA
National Provider Identifier
1962767814
Registry record updated Jul 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
MA055603 Issued in PA
Practice address
2 Celeste Dr
Johnstown, PA 15905-2832
Phone
(814) 255-6781
Fax
(814) 255-5716
NPI assigned
Jul 6, 2012
Last updated
Jul 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA055603 PA Primary

Addresses

Primary practice location

2 Celeste Dr
Johnstown, PA 15905-2832

Mailing address

2 Celeste Dr
Johnstown, PA 15905-2832
Phone (814) 255-6781

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120907000119 PA Practitioner - Physician Assistant 1658529185 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA055603PAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Windber Hospital, Inc. Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341532800000",
    "number": "1962767814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CELESTE DR",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159052832",
            "telephone_number": "814-255-6781",
            "fax_number": "814-255-5716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CELESTE DR",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159052832",
            "telephone_number": "814-255-6781",
            "fax_number": "814-255-5716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENTZ",
        "first_name": "ANTHONY",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-06",
        "last_updated": "2012-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA055603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.