CENTER FOR ORTHOPAEDIC AND SPORTS MEDICINE PC – Sports Medicine (Orthopaedic Surgery) Physician, NPI 1124088372
Sports Medicine (Orthopaedic Surgery) Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for CENTER FOR ORTHOPAEDIC AND SPORTS MEDICINE PC
720 W Mahoning St Ste 200
Punxsutawney, PA 157671351
Phone: (814) 938-4447
Fax: (814) 938-0750
Type: Location
720 W Mahoning St Ste 100
Punxsutawney, PA 157671351
Phone: (814) 938-4447
Fax: (814) 938-0750
Type: Location
25 Colony Blvd Ste 103
Blairsville, PA 157177971
Phone: (724) 465-2676
Fax: (724) 459-1788
Type: Location
321 Main St Ste 3C
Johnstown, PA 159011632
Phone: (814) 535-6521
Fax: (814) 536-4819
Type: Location
81 Hillcrest Dr
Punxsutawney, PA 157672605
Phone: (814) 938-1809
Type: Location
640, Kolter Drive, Getty Heights, White Township, Indiana County, Pennsylvania, 15701, United States
INDIANA, PA 157013570
Phone: (724) 357-7196
Fax: (724) 357-7279
Type: Mailing
IRMC Overlook, Hospital Road, Ben Avon, White Township, Indiana County, Pennsylvania, 15701, United States
SUITE 160
INDIANA, PA 157013674
Phone: (724) 465-2676
Fax: (724) 349-1830
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2005-03-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20050308001019 | O | Clinic/Group Practice | PA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 15767)
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