Provider Demographics
NPI: | 1962758375 |
---|---|
Name: | OSS ORTHOPAEDIC HOSPITAL, LLC |
Entity type: | Organization |
Organization Name: | OSS ORTHOPAEDIC HOSPITAL, LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CHAD |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | RUTTER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DO |
Authorized Official - Phone: | 717-848-4800 |
Mailing Address - Street 1: | 1861 POWDER MILL RD |
Mailing Address - Street 2: | ATTN MEDICAL STAFF OFFICE |
Mailing Address - City: | YORK |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 17402 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 717-718-2000 |
Mailing Address - Fax: | 717-718-3470 |
Practice Address - Street 1: | 1855 POWDER MILL RD |
Practice Address - Street 2: | |
Practice Address - City: | YORK |
Practice Address - State: | PA |
Practice Address - Zip Code: | 17402-4723 |
Practice Address - Country: | US |
Practice Address - Phone: | 717-848-4800 |
Practice Address - Fax: | 717-741-9867 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-08-03 |
Last Update Date: | 2025-04-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
207L00000X, 207Q00000X, 207QS0010X, 207R00000X, 207X00000X, 207XS0106X, 207XS0117X, 207XX0004X, 208100000X, 2082S0105X, 213ES0103X, 363A00000X, 363L00000X, 367500000X | ||
PA | 282N00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 282N00000X | Hospitals | General Acute Care Hospital | Group - Multi-Specialty | |
No | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty | |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207QS0010X | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine | Group - Multi-Specialty |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
No | 207XS0106X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery | Group - Multi-Specialty |
No | 207XS0117X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine | Group - Multi-Specialty |
No | 207XX0004X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Foot and Ankle Surgery | Group - Multi-Specialty |
No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
No | 2082S0105X | Allopathic & Osteopathic Physicians | Plastic Surgery | Surgery of the Hand | Group - Multi-Specialty |
No | 213ES0103X | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery | Group - Multi-Specialty |
No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
No | 367500000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
PA | 102569451 | Medicaid | |
PA | 102569451 | Medicaid | |
PA | 390325 | Medicare PIN |