Bay City Psychiatry, Llc | |
3250 W. Lake Rd Suite 1 Erie PA 16505-3691 | |
(814) 454-1085 | |
(814) 240-3976 |
Full Name | Bay City Psychiatry, Llc |
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Speciality | Psychiatry & Neurology |
Location | 3250 W. Lake Rd, Erie, Pennsylvania |
Authorized Official Name and Position | Mathew W Sipple (MEDICAL DIRECTOR) |
Authorized Official Contact | 8144541085 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Bay City Psychiatry, Llc 3250 W. Lake Rd Suite 1 Erie PA 16505-3691 Ph: (814) 454-1085 | Bay City Psychiatry, Llc 3250 W. Lake Rd Suite 1 Erie PA 16505-3691 Ph: (814) 454-1085 |
NPI Number | 1770991499 |
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Provider Enumeration Date | 07/25/2014 |
Last Update Date | 02/10/2020 |
Certification Date | 02/10/2020 |
Medicare PECOS PAC ID | 5698088953 |
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Medicare Enrollment ID | O20150716001087 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770991499 | NPI | - | NPPES |
1035742960001 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | OS13457 (Pennsylvania) | Primary |
Provider Name | Mathew W Sipple |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1700958428 PECOS PAC ID: 3274620901 Enrollment ID: I20071029000134 |
Provider Name | Charlotte E Riddle |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093958779 PECOS PAC ID: 9335293901 Enrollment ID: I20090817000195 |
Provider Name | Jamie M Fuhrer |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1679738124 PECOS PAC ID: 1658537691 Enrollment ID: I20120719000439 |
Provider Name | Ann M Griesacker |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437442993 PECOS PAC ID: 8628211927 Enrollment ID: I20130906000173 |
Provider Name | Julie M Mannarino |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1467951988 PECOS PAC ID: 7618230301 Enrollment ID: I20180411000227 |
Provider Name | Steven J Harper |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205348638 PECOS PAC ID: 8224386305 Enrollment ID: I20180806003019 |
Provider Name | Jeannie Bauer |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073185583 PECOS PAC ID: 1052718939 Enrollment ID: I20210920001541 |
Provider Name | Ryan A Pastewka |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336821339 PECOS PAC ID: 0749634798 Enrollment ID: I20230926001515 |
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