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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

PLASTIC SURGERY CENTER OF PA
NPI 1609987759
Plastic Surgery in Erie, PA

Active since August 31, 2006CLIA 39D2191520 · Waiver
5040 W RIDGE RD STE 200, ERIE, PA 16506(814) 480-8220(814) 480-8224 Get Directions Write a Review

NPPES record last updated: July 28, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 28, 2026, Jul 21, 2026, Apr 8, 2026 and 1 more (4 updates tracked since 2023).

About Plastic Surgery Center Of Pa NPPES

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

PLASTIC SURGERY CENTER OF PA (NPI 1609987759) is a healthcare organization registered as a plastic surgery in Erie, Pennsylvania and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through August 27, 2026 and lists Gunner Eo Bergqvist, President, as its authorized official.

NPPES Registry Identity

NPI1609987759
Entity TypeOrganization
Primary Taxonomy208200000X
Legal Business NamePLASTIC SURGERY CENTER OF PA
Location Address5040 W RIDGE RD STE 200Erie, PA 16506-1261
Mailing Address5040 W Ridge Rd Ste 200Erie, PA 16506-1261 · (814) 480-8220 · Fax (814) 480-8225
Phone(814) 480-8220
Fax(814) 480-8224
Organization SubpartNo
Authorized OfficialGunner Eo BergqvistPresident · (814) 480-8220
Enumeration DateAugust 31, 2006
Last NPPES UpdateJuly 28, 20264 updates tracked since enumeration
NPPES CertifiedJuly 28, 2026
✔ NPI 1609987759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
Definition
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
5040 W RIDGE RD STE 200, Erie, PA 16506
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 39D2191520

Plastic Surgery Center Of PA · Erie, PA
Active · expires Aug 27, 2026
CLIA Number39D2191520
Laboratory TypePhysician Office
Certificate Effective DateAugust 28, 2024
Certificate Expiration DateAugust 27, 2026
Laboratory DirectorDr. Gunnar Bergqvist
Laboratory Phone(814) 480-8220
Laboratory LocationPlastic Surgery Center Of PA410 Cranberry St, Unit 310, Erie, PA 16507
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RYAN S MAROVICH MPAS, PA-C
Physician Assistant
5040 W RIDGE RD STE 200
ERIE, PA 16506
Erie County (814) 480-8220

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 Plastic Surgery Center Of PA's NPI number?

The NPI number for Plastic Surgery Center Of PA is 1609987759. It was assigned to this organization in the NPPES registry on August 31, 2006.

Where is Plastic Surgery Center Of PA located?

Plastic Surgery Center Of PA is located at 5040 W Ridge Rd Ste 200, Erie, PA 16506. The listed phone number is (814) 480-8220.

What is Plastic Surgery Center Of PA's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Does Plastic Surgery Center Of PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D2191520) is associated with this NPI, valid through August 27, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Plastic Surgery Center Of PA was last updated on July 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 days 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.