ILUMINA LIFE CENTER, P.C. (NPI# 1295101715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295101715 |
| Entity Type | Organization |
| Organization Name | ILUMINA LIFE CENTER, P.C. |
| Practice Address |
507 Tire Hill Rd Suite 100 Johnstown PA 15905-7311 |
| Mailing Address |
136 Jaycee Dr Suite 10 Johnstown PA 15904-3650 |
| Practice Telephone | 8144674055 |
| Practice Fax Number | 8142629816 |
| Mailing Telephone | 8144674055 |
| Mailing Fax Number | 8146268161 |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2018-05-07 |
| Authorized Official Name | FLORENTINA MAYKO (CEO) |
| Authorized Official Telephone | 8144674055 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467852996 | Ilumina Life Center, P.C. | Clinic/Center | 211 Granite Run Dr Ste 221, Lancaster, PA 17601 | 2014-09-03 |
| 1942686753 | Ilumina Life Center, P.C. | Pain Medicine | 418 N Logan Blvd, Suite B, Burnham, PA 17009-1816 | 2015-08-04 |
| Street Address |
507 TIRE HILL RD SUITE 100 |
| City | JOHNSTOWN |
| State | PA |
| Zip Code | 15905-7311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457786253 | Lighthouse Medical, LLC | Anesthesiology | 507 Tire Hill Rd, Suite 100, Johnstown, PA 15905-7311 | 2013-09-11 |
| 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 |
| 1821206178 | Blue and Green Medical PC | Internal Medicine | 1743 Goucher Street, Johnstown, PA 15905 | 2007-05-18 |
| Find all providers in zip 15905 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| 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 Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457786253 | Lighthouse Medical, LLC | Anesthesiology | 507 Tire Hill Rd, Suite 100, Johnstown, PA 15905-7311 | 2013-09-11 |
| 1316381155 | Beacon Medical, LLC | Anesthesiology | 136 Jaycee Dr, Suite 10, Johnstown, PA 15904-3650 | 2013-04-23 |
| 1427051440 | Conemaugh Health Initiatives | Anesthesiology | 1086 Franklin St, Ste A401, Johnstown, PA 15905-4305 | 2005-05-23 |
| 1184730129 | Laurel Group Anesthesia PC | Anesthesiology | 1086 Franklin St, Suite M4000, Johnstown, PA 15905-4305 | 2006-08-22 |
| 1629073069 | William Fritz | Anesthesiology | 1086 Franklin St, Ste A401, Johnstown, PA 15905-4305 | 2005-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629630504 | Bac Medical, Pllc | Anesthesiology | 3070 Bristol Pike # 2-130, Bensalem, PA 19020-5364 | 2019-07-01 |
| 1285294983 | Thomas Falasca | Anesthesiology | 411 Sybil Dr, Erie, PA 16505-2152 | 2019-06-17 |
| 1144711235 | Amy L. Croushore | Anesthesiology | 5750 Centre Ave Ste 400, Pittsburgh, PA 15206-3761 | 2018-05-23 |
| 1023521598 | Michaela R Lewis | Anesthesiology | 333 State St Ste 104, Erie, PA 16507-1463 | 2017-11-07 |
| 1457704652 | Guthrie Medical Group, P.C. | Anesthesiology | 37 Pratt Avenue, Towanda, PA 18848 | 2016-07-22 |
| 1932518669 | Pharo Pain Management Asociates, P.C. | Anesthesiology | 829 Spruce St Ste 308, Philadelphia, PA 19107-5752 | 2014-08-06 |
| 1992137103 | Anish Sethi | Anesthesiology | 834 Chestnut St Ste T150, Philadelphia, PA 19107 | 2013-07-30 |
| 1528407392 | Soon Yong Jung | Anesthesiology | 1240 S Cedar Crest Blvd Ste 307, Allentown, PA 18103-6263 | 2013-06-14 |
| 1407299902 | Mina Ghaly | Anesthesiology | 1200 W Tabor Rd Fl 4, Philadelphia, PA 19141-3019 | 2013-04-15 |
| 1740532779 | Sepa-abington | Anesthesiology | 1327 Old York Rd, Abington, PA 19001-3403 | 2012-10-15 |
| Find all providers with the same taxonomy | ||||
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| 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.