| Broad Top Area Medical Center Inc | |
|
4133 Medical Center Drive, Box 127 Broad Top PA 16621-0127 | |
| (814) 635-2916 | |
| (814) 635-2918 |
| Full Name | Broad Top Area Medical Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4133 Medical Center Drive, Box 127, Broad Top, Pennsylvania |
| Authorized Official Name and Position | John Roth (CEO) |
| Authorized Official Contact | 8146352916 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Broad Top Area Medical Center Inc 4133 Medical Center Drive, Box 127 Broad Top PA 16621-0127 Ph: (814) 635-2916 | Broad Top Area Medical Center Inc 4133 Medical Center Drive, Box 127 Broad Top PA 16621-0127 Ph: (814) 635-2916 |
| NPI Number | 1063514453 |
|---|---|
| Provider Enumeration Date | 09/05/2006 |
| Last Update Date | 04/22/2021 |
| Medicare PECOS PAC ID | 2860430972 |
|---|---|
| Medicare Enrollment ID | O20050420000158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063514453 | NPI | - | NPPES |
| 1007496930006 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Michael A Lettieri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285652446 PECOS PAC ID: 4284528704 Enrollment ID: I20040213000242 |
| Provider Name | Anthony J Zinobile |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376528547 PECOS PAC ID: 3779533864 Enrollment ID: I20050126000837 |
| Provider Name | Tracy A Lillie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689650848 PECOS PAC ID: 5597710640 Enrollment ID: I20050322000419 |
| Provider Name | Robert Calvin Lamey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811971989 PECOS PAC ID: 4789788936 Enrollment ID: I20070328000641 |
| Provider Name | Fawzia Haque |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578752291 PECOS PAC ID: 3476641747 Enrollment ID: I20071120000402 |
| Provider Name | Gregory A Strunk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740486281 PECOS PAC ID: 1456488857 Enrollment ID: I20100415000826 |
| Provider Name | Debra B Messner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447407929 PECOS PAC ID: 1052504164 Enrollment ID: I20101021000751 |
| Provider Name | John D. Roth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699772673 PECOS PAC ID: 4284829631 Enrollment ID: I20101110001201 |
| Provider Name | Kevin Capp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588800155 PECOS PAC ID: 7416143284 Enrollment ID: I20101119000436 |
| Provider Name | Bert Altmanshofer |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1467488445 PECOS PAC ID: 0244143972 Enrollment ID: I20120105000349 |
| Provider Name | Sharon E Martin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891884375 PECOS PAC ID: 2769482298 Enrollment ID: I20120222000313 |
| Provider Name | Della Werner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184058638 PECOS PAC ID: 4789801937 Enrollment ID: I20140812000110 |
| Provider Name | Gregor S Thebaud |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326353996 PECOS PAC ID: 9830317403 Enrollment ID: I20140822001022 |
| Provider Name | Tammy M Pennington |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417095746 PECOS PAC ID: 1951453513 Enrollment ID: I20160401001868 |
| Provider Name | Jessica E Dimoff Querry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023439221 PECOS PAC ID: 7012270283 Enrollment ID: I20180423000637 |
| Provider Name | Douglas Ryan Weber |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538466198 PECOS PAC ID: 2365723590 Enrollment ID: I20190131000924 |
| Provider Name | Kelly Elizabeth Maffia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518985605 PECOS PAC ID: 4486994597 Enrollment ID: I20190327000263 |
| Provider Name | Erika Lindsey Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720677370 PECOS PAC ID: 1759790801 Enrollment ID: I20210503000845 |
| Provider Name | Annamarie Denis Hurley |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1093779746 PECOS PAC ID: 1254657745 Enrollment ID: I20220216000352 |
| Provider Name | Michelle Volpe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427773753 PECOS PAC ID: 6002289469 Enrollment ID: I20230306000950 |
| Provider Name | James Seitz |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1134183767 PECOS PAC ID: 0345615399 Enrollment ID: I20230405002291 |
| Provider Name | David J Uhrik |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1194770818 PECOS PAC ID: 9436437969 Enrollment ID: I20230804001733 |
| Provider Name | Mahesh Botejue |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407484173 PECOS PAC ID: 7113308123 Enrollment ID: I20230915003595 |
| Provider Name | Hope Saylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003696295 PECOS PAC ID: 6002263761 Enrollment ID: I20231117000617 |
| Provider Name | Andrew Joseph Thiry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740002609 PECOS PAC ID: 7012437577 Enrollment ID: I20250305000338 |
| Provider Name | Paige Elizabeth White |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1801632617 PECOS PAC ID: 0941722029 Enrollment ID: I20250318002621 |