NPIMap

Organization Active NPI

Eastside Medical Center

  • Family Medicine Physician
  • Erie, PA
National Provider Identifier
1992926786
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EASTSIDE MEDICAL CENTER
Practice address
2625 Parade St
Erie, PA 16504-2809
Phone
(814) 452-6382
NPI assigned
May 1, 2007
Last updated
Nov 7, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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

Authorized official

Name
Dennis Styn
Title
President
Phone
(814) 866-8468

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X
Obstetrics & Gynecology Physician 207V00000X
Ophthalmology Physician 207W00000X
Orthopaedic Surgery Physician 207X00000X
Pediatrics Physician 208000000X
Surgery Physician 208600000X
Hospitalist Physician 208M00000X

Addresses

Primary practice location

2625 Parade St
Erie, PA 16504-2809

Mailing address

2625 Parade St
Erie, PA 16504-2809
Phone (814) 452-6382

Other identifiers 1

IdentifierTypeStateIssuer
0007045720001MedicaidPA

Other names 1

  • Medical Associates of Erie Other name

National Provider Directory

National Provider Directory
Tax ID family
Medical Associates of Erie Inc36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

Practitioners & affiliated clinicians

Practitioners 5

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": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194393600000",
    "number": "1992926786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 PARADE ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165042809",
            "telephone_number": "814-452-6382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 PARADE ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165042809",
            "telephone_number": "814-452-6382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-11-07",
        "status": "A",
        "authorized_official_last_name": "STYN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-866-8468"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007045720001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Associates of Erie",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; 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.