ERIC E. PETTERSON P.C.
NPI 1245787530
Internal Medicine - Addiction Medicine in Mahanoy City, PA
NPI Status: Active since September 05, 2016
Contact Information
411 W PINE ST
MAHANOY CITY, PA
ZIP 17948
Phone: (570) 773-1101
Fax: (570) 773-1103
Some details in this NPI profile have been updated in the NPI registry within the last 30 days.
- Organization
- Internal Medicine
- Addiction Medicine
- Accepts Insurance
- CLIA Number: 39D2154077
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 09-05-2026
About ERIC E. PETTERSON P.C.
This page provides the complete NPI Profile along with additional information for Eric E. Petterson P.c., an internist established in Mahanoy City, Pennsylvania operating as a Internal Medicine, focusing in addiction medicine . The healthcare provider is registered in the NPI registry with number 1245787530 assigned on September 2016. The practitioner's primary taxonomy code is 207RA0401X with license number MD039636L (PA). The provider is registered as an organization and their NPI record was last updated August 2025. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's
- NPI
- 1245787530
- Provider Legal Name
- ERIC E. PETTERSON P.C.
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 411 W PINE ST MAHANOY CITY, PA 17948
- Location Phone
- (570) 773-1101
- Location Fax
- (570) 773-1103
- Mailing Address
- 411 W PINE ST MAHANOY CITY, PA 17948
- Mailing Phone
- (570) 861-0802
- Mailing Fax
- (570) 773-1103
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-05-2016
- Last Update Date
- 08-26-2025
- Code Navigator
An internist like Eric E. Petterson P.c. is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
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
Internal Medicine Addiction Medicine
- Taxonomy Code
- 207RA0401X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MD039636L
- License State
- PA
- Taxonomy Description
- An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.
Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Silver - HMO
- Elite Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Premier Bronze HSA - EPO
- Premier Bronze HSA + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
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.
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 |
|---|---|---|---|
| 0010036980010 | MEDICAID (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
- 39D2154077
- Facility Type
- Physician Office
- Certificate Effective Date
- September 06, 2024
- Certificate Expiration Date
- September 05, 2026
- Laboratory Director
- DR. ERIC E. PETTERSON
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Eric E. Petterson P.c. 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 Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 4 | 5 | 7 | 8 | 7 | 5 | 3 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 8 | 5 | 14 | 8 | 14 | 5 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 8 + 5 + 1 + 4 + 8 + 1 + 4 + 5 + 6 + 24 = 70 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1245787530 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1245787530, enumerated in the NPI registry as an "organization" on September 05, 2016
The provider is located at 411 W Pine St Mahanoy City, Pa 17948 and the phone number is (570) 773-1101
This medical organization specializes in Internal Medicine with taxonomy code 207RA0401X with a focus in Addiction Medicine
The provider might be accepting Accepts: Ambetter Health, Ambetter Health of Delaware,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 39D2154077 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued 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..
This NPI record was last updated on September 05, 2016. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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