| Bridgeport Express Care Inc | |
|
1370 Johnson Ave Fl 1 Bridgeport WV 26330-1492 | |
| (304) 842-3330 | |
| (304) 842-3303 |
| Full Name | Bridgeport Express Care Inc |
|---|---|
| Speciality | General Practice |
| Location | 1370 Johnson Ave Fl 1, Bridgeport, West Virginia |
| Authorized Official Name and Position | Timothy Peasak (PRESIDENT) |
| Authorized Official Contact | 3048423330 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridgeport Express Care Inc 1370 Johnson Ave Fl 1 Bridgeport WV 26330-1492 Ph: (304) 842-3330 | Bridgeport Express Care Inc 1370 Johnson Ave Fl 1 Bridgeport WV 26330-1492 Ph: (304) 842-3330 |
| NPI Number | 1912142001 |
|---|---|
| Provider Enumeration Date | 12/04/2008 |
| Last Update Date | 01/03/2025 |
| Medicare PECOS PAC ID | 8325104896 |
|---|---|
| Medicare Enrollment ID | O20090309000095 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912142001 | NPI | - | NPPES |
| 3810013952 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Timothy Michael Peasak |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720142391 PECOS PAC ID: 0446242549 Enrollment ID: I20040331000049 |
| Provider Name | David Paul Peasak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316987001 PECOS PAC ID: 9335137074 Enrollment ID: I20040503001023 |
| Provider Name | Natalie R King-selario |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225214240 PECOS PAC ID: 3577619097 Enrollment ID: I20090924000003 |
| Provider Name | Maria Bridgette Scudere |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962036509 PECOS PAC ID: 7416388871 Enrollment ID: I20200519001947 |
| Provider Name | Travis Lee Wamsley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295406833 PECOS PAC ID: 7618365271 Enrollment ID: I20211101001578 |
Community Care Of West Virginia, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 100 Market Pl, Bridgeport, WV 26330 Phone: 304-848-5770 Fax: 304-848-0890 | |
Mountainstate Infectious Disease, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 215 W Main St Ste B, Bridgeport, WV 26330 Phone: 301-641-1822 Fax: 304-250-9933 | |
United Hospital Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330 Phone: 681-342-3600 Fax: 681-342-3625 | |
United Hospital Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 527 Medical Park Dr Ste 402, Bridgeport, WV 26330 Phone: 681-342-3690 | |
Par Wellness Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1221 Johnson Ave, Suite 1100, Bridgeport, WV 26330 Phone: 304-848-0338 | |
Community Care Of West Virginia, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 515 Johnston Avenue, Bridgeport, WV 26330 Phone: 304-326-7137 Fax: 304-587-2594 | |
Michael T Angotti Md Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 527 Medical Park Dr, Suite 307, Bridgeport, WV 26330 Phone: 304-933-3332 Fax: 304-933-3319 |