BLUE AND GREEN MEDICAL PC (NPI# 1821206178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821206178 |
| Entity Type | Organization |
| Organization Name | BLUE AND GREEN MEDICAL PC |
| Practice Address |
1743 Goucher Street Johnstown PA 15905 |
| Mailing Address |
Po Box 819 Johnstown PA 15907-0819 |
| Practice Telephone | 8142550102 |
| Practice Fax Number | 8142550100 |
| Mailing Telephone | 8142550102 |
| Mailing Fax Number | 8142550100 |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. NELLY G TEPPER (OWNER) |
| Authorized Official Telephone | 8142550102 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MD059706L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | HIGHMARK INDIVIDUAL | 883775 | 01 |
| PA | 0015959820012 | 05 | |
| PA | HIGHMARK GROUP | 1553821 | 01 |
| Street Address |
1743 GOUCHER STREET |
| City | JOHNSTOWN |
| State | PA |
| Zip Code | 15905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528552445 | Kristina Marie Sloan | Registered Nurse | Womens Center At Memorial Medical Center, 1111 Franklin St, Suite 210, Johnstown, PA 15905 | 2018-06-15 |
| 1376921403 | Joel Edward Messom | Obstetrics & Gynecology | 1111 Franklin St Ste 300, Johnstown, PA 15905 | 2015-05-08 |
| 1497091797 | Jessica Pacsai | Occupational Therapist | 807 Goucher Street, Johnstown, PA 15905 | 2012-12-14 |
| 1225396351 | Lusine Mesropyan | Surgery | 1086 Franklin Street Good Samaritan Building, Johnstown, PA 15905 | 2012-04-26 |
| 1467766931 | Kimberly Buchanan | Speech-Language Pathologist | 787 Goucher Street, Johnstown, PA 15905 | 2010-07-27 |
| 1205149846 | Lighthouse Medical, LLC | Clinic/Center | 507 Tire Hill Road, Suite 100, Johnstown, PA 15905 | 2010-07-26 |
| 1932357878 | Michael Cameron Sleet | Surgery | Dlp Conemaugh Memorial Hospital, 1086 Franklin Street, Johnstown, PA 15905 | 2008-09-04 |
| 1255528543 | Assisted Living Concepts Inc | Assisted Living Facility | 500 Cheney Oaks Drive, Johnstown, PA 15905 | 2007-10-01 |
| 1578766648 | Tamera Waggle | Nurse Anesthetist, Certified Registered | 1186 Franklin St., Johnstown, PA 15905 | 2007-06-07 |
| 1295818714 | Frank Thomas Zock Jr. | Physical Therapist | 927 Menoher Blvd, Johnstown, PA 15905 | 2006-10-21 |
| Find all providers in zip 15905 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710393715 | Dlp Conemaugh Physician Practices LLC | Internal Medicine | 622 Dermuth St., Johnstown, PA 15904 | 2014-07-10 |
| 1063772838 | St. Mary's Healthcare | Internal Medicine | 700 South Perry St, Johnstown, NY 12095 | 2012-05-25 |
| 1013128495 | Subarna Hamid Eisaman | Internal Medicine | 337 Somerset Street, Upmc-john P. Murtha Regional Cance, Department of Radiation Oncology, Johnstown, PA 15901 | 2007-05-25 |
| 1467598755 | Vijay K Malhotra | Internal Medicine | 78 Fairfield Ave, Johnstown, PA 15906-2308 | 2007-01-30 |
| 1396820759 | Akber Hassam | Internal Medicine | 2 Fon Clair Ter, Johnstown, NY 12095-3100 | 2006-10-26 |
| 1508976044 | Conemaugh Health Initiatives | Internal Medicine | 941 Pinegrove Ln, Suite A, Johnstown, PA 15905-2504 | 2006-08-30 |
| 1770696619 | Francis Patrick Madden | Internal Medicine | 1425 Scalp Avenue, Ste 29, Johnstown, PA 15904-2831 | 2006-08-16 |
| 1720090558 | Safouh Malhis | Internal Medicine | 100 Susan Dr, Johnstown, PA 15905-2826 | 2006-08-12 |
| 1790794824 | Marc Anthony Masotti | Internal Medicine | 4401a Union St, Johnstown, CO 80534-2800 | 2006-08-07 |
| 1144257098 | Mohan S Mital | Internal Medicine | 1123 Franklin St, Johnstown, PA 15905-4309 | 2006-06-27 |
| Find all providers in JOHNSTOWN | ||||
Please comment or provide details below to improve the information on BLUE AND GREEN MEDICAL PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.