DLP - CONEMAUGH HEALTH SYSTEM - Highmark

1 - CONEMAUGH HEALTH SYSTEMCOMMUNITY BLUE PPO HOME HOST CHOICE PLANCOMMUNITY BLUE HDHP HOME HOST CHOICE PLUS PLAND irectory of ProvidersParticipating at the Enhanced Narrow Network Benefit LevelTable of Contents1 Highmark will use reasonable efforts to validate the accuracy of the HEALTH care professional provider's information and to update the information on a periodic basis. Since information about the HEALTH care provider - including his or her participation in a network and whether he or she is accepting new patients - may change, we recommend that you verify with the provider his or her address, and whether the provider is still participating and accepting new cannot guarantee continued access during the term of your enrollment to a particular HEALTH care provider.

2 However, if your network HEALTH care provider ceases participation with the network, Highmark will provide access to other network providers with equivalent training and understands the importance of helping our members find network HEALTH care providers who are accessible to people with physical disabilities and providers who can communicate with people who have sensory disabilities. If you'd like to know if a particular HEALTH care provider can accommodate these special needs, please contact the provider's office. Or call Member Service at the phone number on your identification This Provider Directory .. 3 Primary Care Physicians .. 5 Primary Care Physicians - Pennsylvania .. 7 Allegheny .. 7 Bedford.

3 7 Blair .. 7 Cambria .. 7 Crawford .. 9 Indiana ..9 Somerset .. 9 Westmoreland .. 9 Women's Care .. 11 Obstetricians/Gynecologists - Pennsylvania .. 13 Blair ..13 Cambria ..13 Somerset ..13 Westmoreland ..13 Nurse-Midwives - Pennsylvania .. 15 Specialists .. 17 Specialists - Pennsylvania .. 19 Specialists - West Virginia .. 27 Facilities .. 29 Facilities - Pennsylvania .. 31 Ancillary Providers .. 33 Ancillary Providers - Pennsylvania .. 35 Behavioral HEALTH - Mental HEALTH Services .. 37BH - Mental HEALTH Services PA .. 39 PCP Language Index .. 41 Index .. 43 ABOUT THIS PROVIDER DIRECTORY Your Community Blue PPO Home Host Choice and Community Blue HDHP Home Host Choice Plus plans give you real choice.

4 Each time you need care, you can choose: In-network providers who participate at the Enhanced narrow network benefit level In-network providers who participate at the Standard network benefit level Out-of-network providersTo make the most of your HEALTH care coverage, you ll want to choose network providers at the Enhanced narrow network benefit level. When you receive care from these providers, you save money. Benefits are paid at your plan s highest level, and you pay the least out of your own HOSPITALS AND OTHER FACILITIES These network hospitals participate at the Enhanced narrow network benefit level: CONEMAUGH Memorial Medical Center CONEMAUGH Meyersdale Medical Center CONEMAUGH Miners Medical Center Nason HospitalThe remaining hospitals and other facilities in the Community Blue network participate at the Standard network benefit level.

5 That means you pay more for inpatient and outpatient care you receive from these following hospitals are not in the Community Blue network, so you pay the most if you choose to receive care from: Magee-Womens Hospital of UPMC UPMC East UPMC McKeesport UPMC Mercy UPMC St. Margaret UPMC Passavant UPMC Presbyterian-Shadyside NETWORK PHYSICIANS AND OTHER PROVIDERSThis directory includes a listing of network professional and other providers who participate at the Enhanced narrow network level of a complete list of all network providers those that participate at the Enhanced and Standard levels of benefits use the online directory at Or call myCare NavigatorSM at 1-888-BLUE-428.

6 A myCare Navigator representative can help you find the right doctor, transfer your medical records and even schedule your first appointment. 3 ULPDU\ &DUH3K\VLFLDQV7 Primary Care Physicians - PennsylvaniaPCP/NPI# 1912290008 ICare Medical 4905 William Penn HwyMonroeville, PA 15146(814) 255-1963 Member(s)Nassar, Nazih, MDShahla, Sammya, MDHospital Affiliation(s)DLP CONEMAUGH Memorial Medical Center, LLCS haron Regional HEALTH SystemPCP/NPI# 1912290008 ICare Medical 4905 William Penn HwyMonroeville, PA 15146(814) 255-1963 Member(s)Malhis, Safouh, MD Hospital Affiliation(s)DLP CONEMAUGH Memorial Medical Center, LLCS haron Regional HEALTH SystemPCP/NPI# 1265848600 CHI Shoenthal 4186 Cortland DriveBox 367 New Paris, PA 15554(814) 839-4108 Member(s)Johnston, Lynn C.

7 , MD Shoenthal, Henry W., MD Wright, Lynn M., MDHospital Affiliation(s)DLP CONEMAUGH Memorial Medical Center, LLCUPMC Bedford MemorialWindber Medical CenterPCP/NPI# 1194767426 Southern Cove Medical Associates 2230 Woodbury PikeSuite 2 Loysburg, PA 16659(814) 766-3485 Member(s)Dilling, Duane P., DO McLucas, Patrick B., DOHospital Affiliation(s)Nason HospitalPCP/NPI# 1265848600 CHI Shoenthal 4186 Cortland DriveBox 367 New Paris, PA 15554(814) 839-4108 Member(s)Khalil, Basma M., MDHospital Affiliation(s)DLP CONEMAUGH Memorial Medical Center, LLCUPMC Bedford MemorialWindber Medical CenterPCP/NPI# 1194767426 Southern Cove Medical Associates 2230 Woodbury PikeSuite 2 Loysburg, PA 16659(814) 766-3485 Member(s)Dunmore, Elizabeth W.

8 , MD Hospital Affiliation(s)Nason HospitalPCP/NPI# 1245279165 Claysburg Medical Associates Inc Open to Existing Patients Only365 Ward DrivePo Box 267 Claysburg, PA 16625(814) 239-2211 Member(s)Bulger, Donald W., MD Hospital Affiliation(s)Nason HospitalPCP/NPI# 1023081429 Cove Family Practice Inc 111 Nason DriveSuite 101 Roaring Spring, PA 16673(814) 224-5132 Member(s)Johnson, Daniel W., MD Locke, Darron B., MDHospital Affiliation(s)Nason HospitalUPMC AltoonaPCP/NPI# 1154588499 Heaton Family Practice LLC Open to Existing Patients Only111 Nason DriveSuite 103 Roaring Spring, PA 16673(814) 224-2213 Member(s)Heaton, Fred M., DO Hospital Affiliation(s)Nason HospitalPCP/NPI# 1194767426 Southern Cove Medical Associates Practice limited to 12 years and older 113 June DriveRoaring Spring, PA 16673(814) 224-25371890 North Juniata StreetHollidaysburg, PA 16648(814) 693-7822 Member(s)Dilling, Duane P.

9 , DO McLucas, Patrick B., DOHospital Affiliation(s)Nason HospitalPCP/NPI# 1194767426 Southern Cove Medical Associates Practice limited to 12 years and older 113 June DriveRoaring Spring, PA 16673(814) 224-25371890 North Juniata StreetHollidaysburg, PA 16648(814) 693-7822 Member(s)Dunmore, Elizabeth W., MD Hospital Affiliation(s)Nason HospitalPCP/NPI# 1326439803 Nason Pediatrics 105 Hillcrest DriveRoaring Spring, PA 16673(814) 224-2555 Member(s)Cabe, Ellen M., MDCastel, Joseph A., MD Syed, Razia P., MD Hospital Affiliation(s)Nason HospitalUPMC AltoonaPCP/NPI# 1417906413 Beatty, Lawrence Thomas MD Practice limited to 18 years and older 201 College Park PlazaSuite 2 Johnstown, PA 15904(814) 266-8800 Member(s)Beatty, Lawrence T.

10 , MD Hospital Affiliation(s)DLP CONEMAUGH Memorial Medical Center, LLCPCP/NPI# 1396083945 Cambria Family Practice LLC 1704 Philadelphia AvenueNorthern Cambria, PA 15714(814) 948-0775 Member(s)Vasil, John M., DO Hospital Affiliation(s)DLP CONEMAUGH Memorial Medical Center, LLCDLP CONEMAUGH Miners Medical Center, LLCPCP/NPI# 1689080657 CHI Berkley Hills 1 Tech Park DriveSuite 1130 Johnstown, PA 15901(814) 475-8700318 Goucher StreetJohnstown, PA 15905(814) 288-4488 Member(s)Yokitis, John W., DO Hospital Affiliation(s)DLP CONEMAUGH Memorial Medical Center, LLCDLP CONEMAUGH Miners Medical Center, LLCPCP/NPI# 1740696194 CHI Cresson Famly Practice 225 Keystone AvenueCresson, PA 16630(814) 886-4635 Member(s)Raymond, Paul A.