NPIMap

Organization Active NPI

Excela Health Physician Practices, Inc.

  • Internal Medicine Physician
  • Jeannette, PA
National Provider Identifier
1972776482
Registry record updated Feb 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
EXCELA HEALTH PHYSICIAN PRACTICES, INC.
Practice address
520 Jefferson Ave
Suite 505
Jeannette, PA 15644-2538
Phone
(724) 527-1145
Fax
(724) 527-3535
NPI assigned
Apr 4, 2008
Last updated
Feb 11, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
EXCELA HEALTH HOLDING COMPANYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 11, 2019

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

Authorized official

Name
Renee M Varney
Title
Credentialng Coordinator
Phone
(724) 850-6933

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

520 Jefferson Ave
Suite 505
Jeannette, PA 15644-2538

Mailing address

134 Industrial Park Rd Ste 1500
Greensburg, PA 15601-8153
Phone (724) 850-6933

Other names 1

  • Excela Health Internal Med - Jeannette Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040322001393 PA Part B Supplier - Clinic/Group Practice 6204737117 Receives reassigned benefits from 767 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1207267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549843200000",
    "number": "1972776482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 INDUSTRIAL PARK RD STE 1500",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156018153",
            "telephone_number": "724-850-6933",
            "fax_number": "724-522-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 JEFFERSON AVE",
            "address_2": "SUITE 505",
            "city": "JEANNETTE",
            "state": "PA",
            "postal_code": "156442538",
            "telephone_number": "724-527-1145",
            "fax_number": "724-527-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELA HEALTH PHYSICIAN PRACTICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXCELA HEALTH HOLDING COMPANY",
        "enumeration_date": "2008-04-04",
        "last_updated": "2019-02-11",
        "status": "A",
        "authorized_official_last_name": "VARNEY",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALNG COORDINATOR",
        "authorized_official_telephone_number": "724-850-6933"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excela Health Internal Med - Jeannette",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Excela Health Internal Med - Jeannette",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jeannette, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; 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.