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STATE COLLEGE MEDICAL
NPI 1043520240
Clinic/Center - Methadone in State College, PA

Active since October 21, 2010CLIA 39D2125663 · Waiver
3091 ENTERPRISE DR, STATE COLLEGE, PA 16801(814) 235-6988(814) 235-6989 Get Directions Write a Review

NPPES record last updated: December 23, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 23, 2019, Dec 6, 2019 (2 updates tracked since 2019).

About State College Medical NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STATE COLLEGE MEDICAL (NPI 1043520240) is a healthcare organization registered as a methadone in State College, Pennsylvania and active in the NPI registry since October 2010. The organization holds a CLIA Waiver certificate valid through February 10, 2027 and lists Robyn Tanis, Executive Director Of Contract Mgmt, as its authorized official.

NPPES Registry Identity

NPI1043520240
Entity TypeOrganization
Primary Taxonomy261QM2800X
Legal Business NamePA CARE, LLC
Location Address3091 ENTERPRISE DRState College, PA 16801-3099
Mailing Address1317 Route 73 Ste 200Mount Laurel, NJ 08054-2202 · (856) 439-6111 · Fax (814) 235-6989
Phone(814) 235-6988
Fax(814) 235-6989
Organization SubpartNo
Authorized OfficialRobyn TanisExecutive Director Of Contract Mgmt · (856) 533-8762
Enumeration DateOctober 21, 2010
Last NPPES UpdateDecember 23, 20192 updates tracked since enumeration
✔ NPI 1043520240 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · MethadoneAmbulatory Health Care Facilities
Taxonomy Code261QM2800X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.
3091 ENTERPRISE DR, State College, PA 16801
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Other Names 1

Doing Business AsState College Medical

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 39D2125663

State College Medical · State College, PA
Active · expires Feb 10, 2027
CLIA Number39D2125663
Laboratory TypeAlcohol & Drug Treatment
Certificate Effective DateFebruary 11, 2025
Certificate Expiration DateFebruary 10, 2027
Laboratory DirectorDr. Thomas Baumgarten
Laboratory Phone(814) 235-6988
Laboratory LocationState College Medical3091 Enterprise Drive, Suite 150, State College, PA 16801
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatm G2067
Medication Assisted Treatment (MAT) with methadone is a comprehensive approach to manage opioid addiction. It includes weekly methadone dispensing, substance use counseling, individual and group therapy sessions, and toxicology tests as needed, all provided by a Medicare-enrolled opioid treatment program.
426 services13 patients

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is PA Care, LLC's NPI number?

The NPI number for PA Care, LLC is 1043520240. It was assigned to this organization in the NPPES registry on October 21, 2010. The provider is doing business as State College Medical.

Where is PA Care, LLC located?

PA Care, LLC is located at 3091 Enterprise Dr, State College, PA 16801. The listed phone number is (814) 235-6988.

What is PA Care, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Methadone, with taxonomy code 261QM2800X.

Does PA Care, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D2125663) is associated with this NPI, valid through February 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does PA Care, LLC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list PA Care, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for PA Care, LLC was last updated on December 23, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.