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

Q: 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.

Q: What is Plastic Surgery Center Of PA's specialty?

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

Active since August 31, 2006

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: October 18, 2026.

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

On this page

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 maintains a secondary practice location in Erie 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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Secondary Practice Location 1

Location 1410 Cranberry St, Suite 310Erie, PA 16507-1067 · Phone (814) 480-8220 · Fax (814) 480-8225

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

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Plastic Surgery Center Of Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StatePennsylvaniaEnrollment IDO20031217000375Non-DME Part B · Clinic/Group PracticeDue dateMarch 31, 2027

Source: CMS Revalidation Due Date List, October 2026 release.

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.

Is Plastic Surgery Center Of PA enrolled in Medicare?

Yes. Plastic Surgery Center Of PA is registered in the Medicare PECOS enrollment system.

When is Plastic Surgery Center Of PA's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Pennsylvania, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

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 2 months 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.