Active NPI 1871519637 Individual Practitioner Male Practitioner

Dr. Luis Carlos Gonzalez , MD

Surgery • Bradford, PA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Luis Gonzalez, MD is a certified Surgery practicing in Bradford, PA. With approximately 43 years of clinical experience since completing medical education in 1983, Dr. Gonzalez delivers high-quality medical care to the local community at 181 INTERSTATE PKWY.

Dr. Gonzalez is affiliated with Bradford Regional Medical Services and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, punch biopsy, first skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

181 Interstate Pkwy

Bradford, PA 167011041

Telephone 8143624345

Fax 8143621178

Associated Practice Facility / Clinic

🏢 Luis C Gonzalez Md Facility NPI 1154636686

Medicare Profile & Education

Medical School

Other

Graduation Year

1983

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Bradford, PA

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

43 Yrs Matches City Avg

City Avg: 43.0 Yrs

State Avg: 26.1 Yrs

Regional Practice Density

3 Specialists

Practicing in Bradford, PA (1976 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

53.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Gonzalez (43 Years) 43 Yrs

Bradford Specialty Average (43.0 Years) 43.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	122	110	$255.00	$115.89
99213 Established patient office or other outpatient visit, typically 15 minutes	99	88	$180.00	$82.45
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	74	74	$330.00	$152.15
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	47	47	$221.00	$101.08
11104 Punch biopsy, first skin growth	35	32	$256.00	$106.53
76641 Complete ultrasound scan of 1 breast	31	29	$180.74	$105.97
11105 Punch biopsy, each additional skin growth	15	13	$120.00	$52.43

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	242	206	$255.00	$122.00
99213 Established patient office or other outpatient visit, typically 15 minutes	160	137	$180.00	$86.04
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	103	103	$330.00	$159.67
76641 Complete ultrasound scan of 1 breast	83	70	$282.18	$117.54
45378 Diagnostic exam of large bowel using a flexible endoscope	65	65	$687.00	$174.62
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	53	49	$111.00	$54.11
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	49	49	$221.00	$107.21
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	42	41	$770.00	$104.29
17000 Destruction of skin growth	37	31	$100.00	$64.09
11104 Punch biopsy, first skin growth	37	33	$256.00	$116.48
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	32	14	$141.00	$75.98
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	27	27	$921.00	$227.29
45380 Biopsy of large bowel using an endoscope	27	27	$887.00	$189.85
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	24	24	$391.00	$166.63
17003 Destruction of precancer skin growth, 2-14 growths	18	16	$25.00	$6.33
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	16	15	$609.00	$180.88
11102 Tangential biopsy of single skin lesion	15	13	$207.00	$93.57
76536 Ultrasound of head and neck	12	11	$200.00	$105.86

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	302	253	$255.00	$124.55
99213 Established patient office or other outpatient visit, typically 15 minutes	179	172	$180.00	$88.57
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	132	132	$330.00	$163.43
76641 Complete ultrasound scan of 1 breast	113	85	$227.20	$121.79
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	65	65	$221.00	$109.45
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	58	54	$111.00	$54.97
45378 Diagnostic exam of large bowel using a flexible endoscope	57	56	$687.00	$180.09
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	48	47	$770.00	$110.90
45380 Biopsy of large bowel using an endoscope	39	39	$887.00	$186.34
76536 Ultrasound of head and neck	31	28	$209.35	$110.40
17000 Destruction of skin growth	30	28	$101.00	$65.44
11104 Punch biopsy, first skin growth	29	27	$256.00	$121.95
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	23	23	$391.00	$193.01
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	21	21	$921.00	$222.71
99202 New patient office or other outpatient visit, typically 20 minutes	17	17	$143.00	$70.97
11105 Punch biopsy, each additional skin growth	16	12	$120.00	$58.07
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	16	11	$141.00	$69.13
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	15	13	$356.00	$167.45
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	14	14	$999.71	$209.39
17003 Destruction of precancer skin growth, 2-14 growths	13	13	$24.08	$6.55
11102 Tangential biopsy of single skin lesion	12	12	$207.00	$95.96

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	524	375	$214.84	$127.86
99213 Established patient office or other outpatient visit, typically 15 minutes	331	275	$151.97	$90.28
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	166	166	$294.01	$162.73
76641 Complete ultrasound scan of 1 breast	157	100	$200.78	$126.36
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	125	98	$101.59	$55.29
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	83	79	$756.75	$109.55
45378 Diagnostic exam of large bowel using a flexible endoscope	70	70	$723.10	$174.00
11104 Punch biopsy, first skin growth	67	55	$235.94	$122.28
45380 Biopsy of large bowel using an endoscope	58	58	$939.60	$200.45
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	57	57	$189.16	$110.80
76536 Ultrasound of head and neck	49	42	$214.06	$112.43
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	45	38	$261.29	$169.44
17000 Destruction of skin growth	40	39	$127.83	$64.27
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	35	35	$957.11	$221.68
11102 Tangential biopsy of single skin lesion	25	25	$197.88	$100.13
11105 Punch biopsy, each additional skin growth	25	16	$115.20	$60.12
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	24	24	$994.75	$184.19
99202 New patient office or other outpatient visit, typically 20 minutes	22	22	$129.64	$71.80
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	18	18	$544.00	$201.63
11606 Removal of cancer skin growth of body, arms, or legs, more than 4.0 cm	18	18	$805.11	$433.52
11103 Biopsy of related skin growth, each additional growth	17	16	$102.29	$52.04
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	15	15	$245.33	$197.78
17003 Destruction of precancer skin growth, 2-14 growths	15	14	$15.47	$6.37
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	13	13	$693.69	$262.86
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	13	13	$518.85	$259.75
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	13	11	$527.54	$144.42
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	11	11	$379.82	$219.78
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	11	11	$599.36	$105.54

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	421	328	$144.00	$106.66
99213 Established patient office or other outpatient visit, typically 15 minutes	388	321	$97.00	$73.91
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	186	128	$83.00	$44.64
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	121	121	$155.00	$106.44
76641 Complete ultrasound scan of 1 breast	105	88	$176.00	$112.21
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	105	105	$212.00	$162.45
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	91	36	$92.00	$72.84
45378 Diagnostic exam of large bowel using a flexible endoscope	90	90	$820.00	$185.37
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	90	87	$720.00	$128.05
11104 Punch biopsy, first skin growth	74	67	$160.00	$121.19
45380 Biopsy of large bowel using an endoscope	64	64	$1000.00	$186.45
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	61	59	$218.00	$202.15
76536 Ultrasound of head and neck	41	36	$164.00	$112.94
17000 Destruction of skin growth	38	32	$101.00	$63.58
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	36	34	$1000.00	$253.95
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	29	23	$400.00	$191.37
11105 Punch biopsy, each additional skin growth	29	26	$90.00	$59.76
99202 New patient office or other outpatient visit, typically 20 minutes	27	27	$98.00	$75.08
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	21	21	$1800.00	$345.25
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	19	19	$90.00	$18.93
17003 Destruction of precancer skin growth, 2-14 growths	18	16	$50.00	$5.87
11102 Tangential biopsy of single skin lesion	16	14	$150.00	$95.38
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	15	14	$600.00	$121.61
11606 Removal of cancer skin growth of body, arms, or legs, more than 4.0 cm	14	14	$600.00	$422.13
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	14	14	$990.00	$207.09
19000 Aspiration of breast cyst	13	13	$150.00	$107.81
47562 Removal of gallbladder using an endoscope	13	13	$1950.00	$634.85
49507 Repair of trapped groin hernia patient age 5 years or older	12	12	$1000.00	$580.54
33285 Insertion of heart rhythm monitor under skin	11	11	$500.00	$91.49

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	464	393	$97.00	$71.93
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	429	350	$144.00	$105.19
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	193	193	$155.00	$105.92
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	164	120	$83.00	$43.79
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	143	135	$720.00	$130.47
76641 Complete ultrasound scan of 1 breast	95	81	$180.63	$109.74
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	88	41	$92.00	$72.14
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	79	79	$212.00	$159.59
45380 Biopsy of large bowel using an endoscope	68	68	$976.47	$181.09
45378 Diagnostic exam of large bowel using a flexible endoscope	64	64	$820.00	$184.93
11104 Punch biopsy, first skin growth	58	53	$151.38	$116.99
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	56	56	$1000.00	$231.40
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	52	50	$218.00	$196.73
45388 Destruction of polyp or growth of large bowel using a flexible endoscope	40	40	$1000.00	$278.66
99202 New patient office or other outpatient visit, typically 20 minutes	39	39	$98.00	$74.41
17000 Destruction of skin growth	38	35	$101.00	$62.85
76536 Ultrasound of head and neck	36	30	$162.86	$110.28
33285 Insertion of heart rhythm monitor under skin	35	35	$500.00	$88.82
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	34	31	$400.00	$213.74
11105 Punch biopsy, each additional skin growth	17	17	$90.00	$59.15
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	15	15	$990.00	$209.70
33208 Insertion of pacemaker and upper and lower heart chamber electrode	15	15	$1700.00	$533.42
17003 Destruction of precancer skin growth, 2-14 growths	15	12	$50.00	$5.49
11606 Removal of cancer skin growth of body, arms, or legs, more than 4.0 cm	14	13	$600.00	$444.70
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	14	14	$850.00	$189.76
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	13	13	$1000.00	$189.39
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	11	11	$302.27	$228.43
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	11	11	$385.00	$187.22
11102 Tangential biopsy of single skin lesion	11	11	$150.00	$95.61

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	495	411	$97.00	$70.54
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	325	281	$144.00	$103.90
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	171	171	$155.00	$104.48
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	165	128	$83.00	$42.45
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	164	149	$720.00	$134.13
76641 Complete ultrasound scan of 1 breast	97	77	$179.79	$104.99
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	87	39	$92.00	$70.14
45388 Destruction of polyp or growth of large bowel using a flexible endoscope	83	83	$1000.00	$275.74
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	61	61	$1000.00	$188.24
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	58	58	$212.00	$160.53
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	57	55	$218.00	$196.56
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	44	44	$1000.00	$220.11
17000 Destruction of skin growth	42	35	$101.00	$64.15
99202 New patient office or other outpatient visit, typically 20 minutes	38	38	$98.00	$72.84
33282 Implantation patient-activated heart monitoring device	36	36	$450.00	$227.21
76536 Ultrasound of head and neck	29	23	$164.00	$111.75
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	20	19	$400.00	$212.03
45380 Biopsy of large bowel using an endoscope	20	20	$900.00	$158.37
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	20	20	$1800.00	$341.02
33208 Insertion of pacemaker and upper and lower heart chamber electrode	19	19	$1700.00	$527.64
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	19	19	$90.00	$18.54
45378 Diagnostic exam of large bowel using a flexible endoscope	17	17	$820.00	$167.10
17003 Destruction of precancer skin growth, 2-14 growths	16	14	$50.00	$5.12
11400 Removal of growth (0.5 centimeters or less) of the trunk, arms or legs	14	11	$190.00	$91.00
11640 Removal of malignant growth (0.5 centimeters or less) of the face, ears, eyelids, nose, or lips	13	11	$250.00	$179.75

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	518	412	$97.00	$78.47
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	333	282	$144.00	$114.68
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	183	183	$155.00	$115.37
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	155	116	$83.00	$46.32
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	144	134	$720.00	$139.99
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	118	46	$92.00	$79.47
76641 Complete ultrasound scan of 1 breast	103	79	$175.57	$118.94
45388 Destruction of polyp or growth of large bowel using a flexible endoscope	73	73	$1000.00	$305.17
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	69	69	$1000.00	$204.72
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	62	62	$212.00	$173.58
99202 New patient office or other outpatient visit, typically 20 minutes	61	61	$98.00	$79.55
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	53	52	$218.00	$223.22
17000 Destruction of skin growth	46	38	$101.00	$71.12
76536 Ultrasound of head and neck	44	33	$164.00	$123.48
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	36	36	$997.22	$239.34
45378 Diagnostic exam of large bowel using a flexible endoscope	32	32	$820.00	$204.57
17003 Destruction of precancer skin growth, 2-14 growths	27	23	$50.00	$6.04
36475 Destruction of insufficient vein of arm or leg, accessed through the skin	26	11	$3500.00	$1610.70
45380 Biopsy of large bowel using an endoscope	21	20	$900.00	$130.55
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	18	17	$400.00	$235.38
11640 Removal of malignant growth (0.5 centimeters or less) of the face, ears, eyelids, nose, or lips	17	15	$250.00	$183.19
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	16	16	$90.00	$20.05
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	16	16	$1800.00	$364.31
71023 X-ray of chest, 2 views, front and side with fluoroscopy	14	14	$80.00	$21.06
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	13	13	$990.00	$261.06
33208 Insertion of pacemaker and upper and lower heart chamber electrode	13	13	$1700.00	$566.35
11401 Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm	13	12	$215.00	$111.14
11606 Removal of cancer skin growth of body, arms, or legs, more than 4.0 cm	12	11	$600.00	$468.83
49507 Repair of trapped groin hernia patient age 5 years or older	11	11	$1000.00	$656.53
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	11	11	$150.00	$150.81
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	11	11	$850.00	$216.47

Medical Specialties & State Licenses

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License PA MD054904L

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

0015887450005 (PA)

Hospital & Practice Group Affiliations

Bradford Regional Medical Services

181 Interstate Pkwy, Bradford, PA 167011041

Phone: 8143624345

Bradford Regional Medical Services

515 Main St, Olean, NY 147601513

Phone: 7163732600

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners

Ashley Disney , PA-C

Physician Assistant - Surgical

NPI 1285983973

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active February 18, 2013

NPI status registered as active in NPPES database

📍

Updated Practice Location February 18, 2013

Registered at 181 INTERSTATE PKWY, BRADFORD, PA 167011041 (Tel: 8143624345)

📍

Updated Business Mailing Address February 18, 2013

Registered at 181 INTERSTATE PKWY, BRADFORD, PA 167011041 (Tel: 8143624345)

👤

Provider Name / Credentials Updated February 18, 2013

Recorded as LUIS GONZALEZ, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 18, 2013

Surgery (License #MD054904L in PA)

🟢

Initial NPI Registration & Enumeration July 14, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1871519637

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 14, 2006

Last Update: February 18, 2013

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

181 Interstate Pkwy

Bradford, PA 167011041

Phone: 8143624345

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.