1. Home
  2. Directory
  3. Pennsylvania
  4. Du Bois
  5. Psychiatry Neurology
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

EDGAR BONCHITA GANTALAO M.D.
NPI 1649200411
Psychiatry & Neurology - Psychiatry in Du Bois, PA

Active since July 04, 2006PECOS EnrolledAccepts Medicare Assignment
96.56/100
CMS Quality Rating
535 SUNFLOWER DR, DU BOIS, PA 15801(814) 375-6379(814) 375-9320 Get Directions Write a Review

NPPES record last updated: September 22, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Edgar Bonchita Gantalao M.d. NPPES

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

EDGAR BONCHITA GANTALAO M.D. (NPI 1649200411) is an individual psychiatry provider in Du Bois, Pennsylvania, licensed in Pennsylvania (MD418498) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Penn Highlands Dubois, and is a graduate of Other (1980).

NPPES Registry Identity

NPI1649200411
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameEDGAR BONCHITA GANTALAOCredential: M.D.
Location Address535 SUNFLOWER DRDu Bois, PA 15801-2364
Mailing Address100 Hospital AveDu Bois, PA 15801-1440 · (814) 375-6379 · Fax (814) 375-9320
Phone(814) 375-6379
Fax(814) 375-9320
Sole ProprietorNo
Medical School CMSOtherGraduated 1980
Enumeration DateJuly 4, 2006
Last NPPES UpdateSeptember 22, 2026
NPPES CertifiedSeptember 22, 2026
✔ NPI 1649200411 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in PA · MD418498
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
535 SUNFLOWER DR, Du Bois, PA 15801
Open in Google Maps ↗

Other Identifiers 2

Medicaid0019070610006PA
Other001424280PA · Highmark Bc/bs

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 ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Edgar Bonchita Gantalao M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9638361355
PECOS Enrollment IDI20101012001333
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Edgar Gantalao reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Dubois Regional Medical Center
Same address
Psychiatry
535 SUNFLOWER DR
Du Bois, PA 15801
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 27 clinicians in this Medicare group
NPI 1487848768 (814) 375-6379
Brookville Hospital
18 mi
Multi-Specialty
100 HOSPITAL RD
Brookville, PA 15825
  • Reassigned Medicare billing, Pennsylvania enrollment
  • Also billed through NPI 1568400026 (Pennsylvania)
  • 122 clinicians in this Medicare group
NPI 1578733093 (412) 788-4995
Elk Regional Health Center
38 mi
Multi-Specialty
416 N BROAD ST
Emporium, PA 15834
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 23 clinicians in this Medicare group
NPI 1952554602 (814) 788-8000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
337 services46 patients
Psychiatric diagnostic evaluation with medical services 90792
A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.
37 services34 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
16 services16 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Penn Highlands Dubois

Acute Care Hospitals · Dubois, PA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390086
Location100 Hospital AvenueDubois, PA 15801 · Clearfield County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15801 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$166.87 typical visit price
range $54.64 – $166.87
Typical copayment $41.71 (range $13.66 – $41.71)
Most-billed visit code 99205
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

96.56/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability95.96
Improvement Activities40

Other Providers at the Same Location NPPES 20

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

LANCE THOMPSON PA
Physician Assistant
535 SUNFLOWER DR
DU BOIS, PA 15801
Clearfield County (814) 375-6379
PATRICIA CLOUSER LSW
Social Worker (Clinical)
535 SUNFLOWER DR
DU BOIS, PA 15801
Clearfield County (814) 375-6379
LUKE MICHAEL HASKINS PA-C
Physician Assistant
535 SUNFLOWER DR
DU BOIS, PA 15801
Clearfield County (814) 375-6379
JOSHUA DAVID LOWERY MD
Psychiatry & Neurology (Psychiatry)
535 SUNFLOWER DR
DU BOIS, PA 15801
Clearfield County (814) 375-6338
ALLEN BINOY DSOUZA M.D.
Psychiatry & Neurology (Psychiatry)
535 SUNFLOWER DR
DU BOIS, PA 15801
Clearfield County (814) 375-6379
RENEE Y CURLL LCSW
Social Worker (Clinical)
535 SUNFLOWER DR
DU BOIS, PA 15801
Clearfield County (814) 375-6351
GRACE RUMMEL LCSW
Social Worker (Clinical)
535 SUNFLOWER DR
DU BOIS, PA 15801
Clearfield County (814) 375-6379
JASON EDWARD ROCK MD MPH
Psychiatry & Neurology (Child & Adolescent Psychiatry)
535 SUNFLOWER DR
DU BOIS, PA 15801
Clearfield County (814) 375-6379

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 Edgar Gantalao's NPI number?

The NPI number for Edgar Gantalao is 1649200411. It was assigned to this individual provider in the NPPES registry on July 4, 2006.

Where is Edgar Gantalao located?

Edgar Gantalao practices at 535 Sunflower Dr, Du Bois, PA 15801. The listed phone number is (814) 375-6379.

What is Edgar Gantalao's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Edgar Gantalao enrolled in Medicare?

Yes. Edgar Gantalao is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Edgar Gantalao's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Edgar Gantalao reassigns Medicare benefits to 3 organizations: Dubois Regional Medical Center (Du Bois, PA), Brookville Hospital (Brookville, PA) and Elk Regional Health Center (Emporium, PA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Edgar Gantalao's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Edgar Gantalao accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Edgar Gantalao 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.

Is Edgar Gantalao affiliated with any hospitals?

According to CMS data, Edgar Gantalao is affiliated with Penn Highlands Dubois.

When was this NPI record last updated?

The NPPES record for Edgar Gantalao was last updated on September 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 37 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.