LIGHTHOUSE MEDICAL LLC (NPI# 1528354271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528354271 |
| Entity Type | Organization |
| Organization Name | LIGHTHOUSE MEDICAL LLC |
| Practice Address |
418 N Logan Blvd Suite A Burnham PA 17009-1816 |
| Mailing Address |
311 E. Pleasant Vally Blvd Altoona PA 16602 |
| Practice Telephone | 7172423900 |
| Mailing Telephone | 8149431271 |
| Mailing Fax Number | 8149408516 |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2017-02-28 |
| Authorized Official Name | JOHN H. JOHNSON (CEO/OWNER) |
| Authorized Official Telephone | 81479431271 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208100000X | Physical Medicine & Rehabilitation | MD438515 | PA | Allopathic & Osteopathic Physicians |
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
MD441685 | PA | Allopathic & Osteopathic Physicians |
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
OS015480 | PA | Allopathic & Osteopathic Physicians |
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
MD044867E | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1020712560001 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831478049 | Lighthouse Medical LLC | Physical Medicine & Rehabilitation | 253 Easterly Pkwy, Suite 1, State College, PA 16801-6301 | 2011-08-05 |
| 1881948669 | Lighthouse Medical LLC | Pain Medicine | 601 N Front St, Suite B, Philipsburg, PA 16866-2303 | 2012-11-01 |
| 1841547809 | Lighthouse Medical LLC | Durable Medical Equipment & Medical Supplies | 217 Glenn St, Fourth Floor, Cumberland, MD 21502-2460 | 2012-08-09 |
| 1841580495 | Lighthouse Medical LLC | Anesthesiology | 217 Glenn St, Suite 401, Cumberland, MD 21502-2460 | 2011-04-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Lighthouse Medical LLC | 4750 South Denice Dr., Englewood, CO 80111 |
| Street Address |
418 N LOGAN BLVD SUITE A |
| City | BURNHAM |
| State | PA |
| Zip Code | 17009-1816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407825417 | Pratibha V Vakharia | Specialist | 418 N Logan Blvd, Burnham, PA 17009-1816 | 2006-03-14 |
| 1124498746 | Pain Medicine of York, LLC | Physical Medicine & Rehabilitation | 418 N Logan Blvd, Burnham, PA 17009-1816 | 2015-09-25 |
| 1942686753 | Ilumina Life Center, P.C. | Pain Medicine | 418 N Logan Blvd, Suite B, Burnham, PA 17009-1816 | 2015-08-04 |
| 1518386770 | Allergy & Asthma Specialist LLC | Specialist | 418 N Logan Blvd, Burnham, PA 17009-1816 | 2014-04-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215153929 | Jeffery A. Gilbert | Internal Medicine | 217 South Logan Blvd., Burnham, PA 17009 | 2007-04-18 |
| 1679902571 | Angela Deamer | Case Manager/Care Coordinator | 543 E Freedom Ave, Burnham, PA 17009-1306 | 2013-11-01 |
| 1962855072 | Happy Valley Hab-aide Co. | Community/Behavioral Health | 543 E Freedom Ave, Burnham, PA 17009-1306 | 2016-07-14 |
| 1831252972 | Juniata Valley Foot and Ankle Associates | Durable Medical Equipment & Medical Supplies | 215 N Beech St, Burnham, PA 17009-1600 | 2006-12-19 |
| 1700098084 | Family Health Associates Orthopedics | Orthopaedic Surgery | 215 N Beech St, Burnham, PA 17009-1600 | 2007-05-07 |
| 1972643450 | Lewistown Ambulatory Care Corporation | Internal Medicine | 215 N Beech St, Burnham, PA 17009-1600 | 2007-02-07 |
| 1316950348 | Katherine Terese Harvatine | Optometrist | 231 N Logan Blvd, Wise Eyes Optical, Burnham, PA 17009-1813 | 2006-08-14 |
| 1194958413 | Harvatine Optometry, Inc. | Clinic/Center | 231 N Logan Blvd, Burnham, PA 17009-1813 | 2009-09-03 |
| 1083718829 | Pennsylvania Cvs Pharmacy, L.L.C. | Pharmacy | 404 N Logan Blvd, Burnham, PA 17009-1816 | 2006-09-12 |
| 1255341145 | Dicks Home Care Inc | Durable Medical Equipment & Medical Supplies | 224 N Logan Blvd Ste 8, Burnham, PA 17009-1819 | 2006-08-09 |
| Find all providers in zip 17009 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1457786253 | Lighthouse Medical, LLC | Anesthesiology | 507 Tire Hill Rd, Suite 100, Johnstown, PA 15905-7311 | 2013-09-11 |
| 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 |
| 1316381155 | Beacon Medical, LLC | Anesthesiology | 136 Jaycee Dr, Suite 10, Johnstown, PA 15904-3650 | 2013-04-23 |
| 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.