SENIOR LIFE JOHNSTOWN
NPI 1265584833
Program of All-Inclusive Care for the Elderly (PACE) Provider Organization in Johnstown, PA

NPI Status: Active since January 17, 2007

Contact Information

401 BROAD ST
JOHNSTOWN, PA
ZIP 15906
Phone: (814) 535-6000
Fax: (814) 248-7902

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  • Organization
  • Program of All-Inclusive Care for the El...
  • CLIA Number: 39D1048650
  • CLIA Cert. Type: Other
  • CLIA Exp. Date: 12-06-2027

About SENIOR LIFE JOHNSTOWN

This page provides the complete NPI Profile along with additional information for Senior Life Johnstown, a provider established in Johnstown, Pennsylvania operating as a Program Of All-inclusive Care For The Elderly (pace) Provider Organization. The healthcare provider is registered in the NPI registry with number 1265584833 assigned on January 2007. The practitioner's primary taxonomy code is 251T00000X. The provider is registered as an organization and their NPI record was last updated 10 years ago. The provider's is doing business as Senior Life Johnstown. The authorized official of this NPI record is Mr. Herbert H Hennell (Director Of Reimbursement)

NPI
1265584833
Provider Legal Name
PENNSYLVANIA PACE, INC.
Other Organization Name
SENIOR LIFE JOHNSTOWN
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
401 BROAD ST JOHNSTOWN, PA 15906
Location Phone
(814) 535-6000
Location Fax
(814) 248-7902
Mailing Address
209 SIGMA DR PITTSBURGH, PA 15238
Mailing Phone
(412) 963-9150
Mailing Fax
(814) 248-7902
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-17-2007
Last Update Date
09-26-2016
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Program of All-Inclusive Care for the Elderly (PACE) Provider Organization

Taxonomy Code
251T00000X
Type
Agencies
License State
PA
Taxonomy Description
A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1253Z00000XAgencies

In Home Supportive Care

9963601 (PA)
2261QA0600XAmbulatory Health Care Facilities

Clinic/Center
Adult Day Care

104070 (PA)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. HERBERT H HENNELL

Authorized Official Title
DIRECTOR OF REIMBURSEMENT
Authorized Official Phone
(412) 963-9150

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
H3925OTHER (01)PAMEDICARE AGREEMENT NUMBER
101362553-0001MEDICAID (05)PA 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
39D1048650
Facility Type
Other
Certificate Effective Date
December 07, 2025
Certificate Expiration Date
December 06, 2027
Laboratory Director
DR. SAMUEL WINT MD
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Senior Life Johnstown to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1265584833, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
5
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
8
Unchanged
Pos 7
4
Doubled → 8
Pos 8
8
Unchanged
Pos 9
3
Doubled → 6
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 5 → 10 → 1 4 → 8 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 2 + 5 + 1 + 0 + 8 + 8 + 8 + 6 + 24 = 67

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 67 is 70. The difference is the calculated check digit.

70 - 67 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1265584833.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Speech-Language Pathologist
401 BROAD ST
JOHNSTOWN, PA 15906
Occupational Therapist
401 BROAD ST
JOHNSTOWN, PA 15906
Family Medicine
401 BROAD ST
JOHNSTOWN, PA 15906
Registered Nurse
401 BROAD ST
JOHNSTOWN, PA 15906
Registered Nurse
401 BROAD ST
JOHNSTOWN, PA 15906
Registered Nurse
401 BROAD ST
JOHNSTOWN, PA 15906
Dietary Manager
401 BROAD ST
JOHNSTOWN, PA 15906
Registered Nurse
401 BROAD ST
JOHNSTOWN, PA 15906
Dietitian, Registered
401 BROAD ST
JOHNSTOWN, PA 15906
Social Worker
401 BROAD ST
JOHNSTOWN, PA 15906
Social Worker
401 BROAD ST
JOHNSTOWN, PA 15906
Registered Nurse
401 BROAD ST
JOHNSTOWN, PA 15906
Registered Nurse
401 BROAD ST
JOHNSTOWN, PA 15906
Registered Nurse
401 BROAD ST
JOHNSTOWN, PA 15906
Registered Nurse
401 BROAD ST
JOHNSTOWN, PA 15906
Social Worker
401 BROAD ST
JOHNSTOWN, PA 15906
Registered Nurse
401 BROAD ST
JOHNSTOWN, PA 15906
Registered Nurse
401 BROAD ST
JOHNSTOWN, PA 15906
Social Worker
401 BROAD ST
JOHNSTOWN, PA 15906
Registered Nurse
401 BROAD ST
JOHNSTOWN, PA 15906

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1265584833, enumerated as an "organization" on January 17, 2007.

The provider is located at 401 BROAD ST JOHNSTOWN, PA 15906 and the phone number is (814) 535-6000.

Program of All-Inclusive Care for the Elderly (PACE) Provider Organization with taxonomy code 251T00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.