NPIMap

Organization Active NPI

Heritage Valley Medical Group, Inc.

  • Family Medicine Physician
  • Clinton, PA
National Provider Identifier
1992957591
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
1254 RT 30
Hillendale Health Center
Clinton, PA 15026
Phone
(724) 573-5600
NPI assigned
Oct 15, 2008
Organization subpart
Yes
Parent organization
TRI-STATE MEDICAL GROUP, INC.As reported in NPPES

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

1254 RT 30
Hillendale Health Center
Clinton, PA 15026

Mailing address

1254 RT 30
Hillendale Health Center
Clinton, PA 15026
Phone (724) 573-5600

Other identifiers 2

IdentifierTypeStateIssuer
0015654460023MedicaidPA
0202677MedicaidOH

Other names 1

  • HVMG John D. Bayak M.D. 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
Part of
Tri - State Medical Group Inc

Organizations with this tax ID in the same state 12

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

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": "1992957591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1254 RT 30",
            "address_2": "HILLENDALE HEALTH CENTER",
            "city": "CLINTON",
            "state": "PA",
            "postal_code": "15026",
            "telephone_number": "724-573-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1254 RT 30",
            "address_2": "HILLENDALE HEALTH CENTER",
            "city": "CLINTON",
            "state": "PA",
            "postal_code": "15026",
            "telephone_number": "724-573-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE VALLEY MEDICAL GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRI-STATE MEDICAL GROUP, INC.",
        "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 John D. Bayak M.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton, 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.