| Pediatric Care Specialists | |
|
1322 Eisenhower Blvd Johnstown PA 15904-3307 | |
| (814) 266-8840 | |
| (814) 266-8840 |
| Full Name | Pediatric Care Specialists |
|---|---|
| Speciality | Clinic/Center |
| Location | 1322 Eisenhower Blvd, Johnstown, Pennsylvania |
| Authorized Official Name and Position | Sherri Lynn Parshall (BILLING CLERK) |
| Authorized Official Contact | 8142668840 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Care Specialists 1322 Eisenhower Blvd Johnstown PA 15904-3307 Ph: (814) 266-8840 | Pediatric Care Specialists 1322 Eisenhower Blvd Johnstown PA 15904-3307 Ph: (814) 266-8840 |
| NPI Number | 1346236833 |
|---|---|
| Provider Enumeration Date | 09/21/2005 |
| Last Update Date | 05/20/2020 |
| Medicare PECOS PAC ID | 9537333604 |
|---|---|
| Medicare Enrollment ID | O20111130000082 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346236833 | NPI | - | NPPES |
| 1007708200003 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | MD-039547-L (Pennsylvania) | Secondary |
| Provider Name | Daniel F Russell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1619902004 PECOS PAC ID: 2163609595 Enrollment ID: I20110610000422 |
| Provider Name | Tracy Tredennick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316116767 PECOS PAC ID: 8729266135 Enrollment ID: I20110706000355 |
| Provider Name | Joseph James Ozbold |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1750722575 PECOS PAC ID: 3476788381 Enrollment ID: I20131031000995 |
| Provider Name | Joshua Watt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164720439 PECOS PAC ID: 6608099692 Enrollment ID: I20140520001343 |
| Provider Name | Ian D Goncher |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891077129 PECOS PAC ID: 5597988980 Enrollment ID: I20140604000830 |
| Provider Name | Venkata R Dharbhamulla |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033272513 PECOS PAC ID: 0840464921 Enrollment ID: I20210707002163 |
| Provider Name | Andrew A. Garbarino |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366503013 PECOS PAC ID: 4587838669 Enrollment ID: I20210719001115 |
| Provider Name | Regina T Kupchella |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932269776 PECOS PAC ID: 6305010489 Enrollment ID: I20210719003653 |
| Provider Name | Edward J Pawlowski |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598960395 PECOS PAC ID: 2062592934 Enrollment ID: I20210723000962 |
| Provider Name | Bradley Russell Drennen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215993340 PECOS PAC ID: 4082017223 Enrollment ID: I20210726000646 |
| Provider Name | Michelle R Sredy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174536676 PECOS PAC ID: 5092118257 Enrollment ID: I20210726001466 |
| Provider Name | Jodi Hockenberry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033637798 PECOS PAC ID: 1052795135 Enrollment ID: I20220908003654 |
| Provider Name | Jessica Berkey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134773625 PECOS PAC ID: 6305207531 Enrollment ID: I20230803001771 |
| Provider Name | Rachael Harrington |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356911911 PECOS PAC ID: 5193179968 Enrollment ID: I20230927002514 |
| Provider Name | Shannon Berkey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003438698 PECOS PAC ID: 2264888932 Enrollment ID: I20231101001412 |
| Provider Name | Sally Shaffer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932872264 PECOS PAC ID: 8628415700 Enrollment ID: I20240325003087 |
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Chi Berkley Hills Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Tech Park Dr, Suite 1130, Johnstown, PA 15901 Phone: 814-475-8700 Fax: 814-475-8796 | |
Chi Gvozden Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Tech Park Dr, Suite 1120, Johnstown, PA 15901 Phone: 814-475-8700 Fax: 814-475-8798 | |
Richard J Green Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 213 Vine St, Johnstown, PA 15901 Phone: 814-535-5841 Fax: 814-539-3424 | |
Nulton Diagnostic & Treatment Center, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 214 College Park Plz, Johnstown, PA 15904 Phone: 814-262-0025 Fax: 814-266-8745 | |
Windber Care Physicians Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1511 Scalp Ave, Johnstown, PA 15904 Phone: 814-254-4207 Fax: 814-254-4733 | |
Fairfield Ave Family Practice Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 226 Fairfield Ave, Johnstown, PA 15906 Phone: 814-535-6167 |