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Dlp - Conemaugh Health System Community Blue Ppo Home Host Choice Plan Community Blue Hdhp Home Host Choice Plus Plan

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Dlp - Conemaugh Health System Community Blue Ppo Home Host Choice Plan Community Blue Hdhp Home Host Choice Plus Plan DLP - CONEMAUGH HEALTH SYSTEM COMMUNITY BLUE PPO HOME HOST CHOICE PLAN COMMUNITY BLUE HDHP HOME HOST CHOICE PLUS PLAN Directory of Providers Participating at the Enhanced Narrow Network Benefit Level HIGHMARKBCBS.COM Table of Contents About This Provider Directory............................................. 3 Primary Care Physicians ....................................................... 5 Primary Care Physicians - Pennsylvania ............................. 7 Allegheny .............................................................................................................. 7 Bedford................................................................................................................... 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 .................... 37 BH - Mental Health Services PA ......................................... 39 PCP Language Index........................................................... 41 Index .................................................................................... 43 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 patients. Highmark cannot guarantee continued access during the term of your enrollment to a particular health care provider. However, if your network health care provider ceases participation with the network, Highmark will provide access to other network providers with equivalent training and expertise. Highmark 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 1call Member Service at the phone number on your identification card. ABOUT THIS PROVIDER DIRECTORY Your Community Blue PPO Home Host Choice and Community The following hospitals are not in the Community Blue Blue HDHP Home Host Choice Plus plans give you real choice. network, so you pay the most if you choose to receive Each time you need care, you can choose: care from: • In-network providers who participate at the Enhanced • Magee-Womens Hospital of UPMC narrow network benefit level • UPMC East • In-network providers who participate at the Standard • UPMC McKeesport network benefit level • UPMC Mercy • Out-of-network providers • UPMC St. Margaret To make the most of your health care coverage, you’ll want to • UPMC Passavant choose network providers at the Enhanced narrow network • UPMC Presbyterian-Shadyside 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 pocket. NETWORK PHYSICIANS AND OTHER PROVIDERS This directory includes a listing of network professional and NETWORK HOSPITALS AND OTHER FACILITIES other providers who participate at the Enhanced narrow These network hospitals participate at the Enhanced narrow network level of benefits. network benefit level: For a complete list of all network providers – those that • Conemaugh Memorial Medical Center participate at the Enhanced and Standard levels of benefits – use the online directory at MyConemaughProviders.com. • Conemaugh Meyersdale Medical Center • Conemaugh Miners Medical Center Or call myCare NavigatorSM at 1-888-BLUE-428. A myCare Navigator representative can help you find the right doctor, • Nason Hospital transfer your medical records and even schedule your first appointment. The remaining hospitals and other facilities in the Community Blue network participate at the Standard network benefit level. That means you pay more for inpatient and outpatient care you receive from these facilities. 3ULPDU\&DUH 3K\VLFLDQV Allegheny / Cambria PCP/NPI# 1467868307 Indiana Regional Medical Center Allegheny Blair Cambria CHI Gvozden Latrobe Area Hospital 128 Fairfield Penn Highlands DuBois Family Practice Family Practice Family Practice Johnstown, PA 15906 Sharon Regional Health System (814) 535-1621 PCP/NPI# 1912290008 PCP/NPI# 1245279165 PCP/NPI# 1417906413 Member(s) PCP/NPI# 1558777995 Primary Care Physicians - Pennsylvania ICare Medical Claysburg Medical Associates Inc Beatty, Lawrence Thomas MD Conemaugh Physician Group St Gvozden, Phillip D., MD Benedict Rural Health Clinic 4905 William Penn Hwy Open to Existing Patients Only Practice limited to 18 years and older Hospital Affiliation(s) Monroeville, PA 15146 365 Ward Drive 201 College Park Plaza 564 Theatre Road (814) 255-1963 DLP Conemaugh Memorial Medical Carrolltown, PA 15722 Po Box 267 Suite 2 Center, LLC Member(s) Claysburg, PA 16625 Johnstown, PA 15904 (814) 344-8477 Nassar, Nazih, MD (814) 239-2211 (814) 266-8800 PCP/NPI# 1831505981 Member(s) Shahla, Sammya, MD Member(s) Member(s) Conemaugh Phy Grp Ebensburg Lieb, Brian E., DO® Hospital Affiliation(s) Bulger, Donald W., MD® Beatty, Lawrence T., MD® Industrial Park Rohanna, Christine M., DO® DLP Conemaugh Memorial Medical Hospital Affiliation(s) Hospital Affiliation(s) 188 Industrial Park Road Hospital Affiliation(s) Center, LLC Nason Hospital DLP Conemaugh Memorial Medical Suite B DLP Conemaugh Memorial Medical Sharon Regional Health System Center, LLC Ebensburg, PA 15931 Center, LLC PCP/NPI# 1023081429 (814) 471-9005 Cove Family Practice Inc PCP/NPI# 1396083945 Member(s) PCP/NPI# 1508869082 Internal Medicine Crawford III, John, DO 111 Nason Drive Cambria Family Practice LLC Rossman Clapper, Nicole L., DO® PCP/NPI# 1912290008 Suite 101 1704 Philadelphia Avenue 170 Fourth Avenue Warner, Michael J., DO® Hastings, PA 16646 ICare Medical Roaring Spring, PA 16673 Northern Cambria, PA 15714 Hospital Affiliation(s) (814) 224-5132 (814) 948-0775 (814) 247-6583 4905 William Penn Hwy DLP Conemaugh Memorial Medical Monroeville, PA 15146 Member(s) Member(s) Member(s) Center, LLC Crawford, III, John, DO (814) 255-1963 Johnson, Daniel W., MD® Vasil, John M., DO® J C Blair Memorial Hospital ® Member(s) Locke, Darron B., MD Hospital Affiliation(s) UPMC Altoona Hospital Affiliation(s) Malhis, Safouh, MD® Hospital Affiliation(s) DLP Conemaugh Memorial Medical DLP Conemaugh Miners Medical Hospital Affiliation(s) Nason Hospital Center, LLC PCP/NPI# 1932515905 Center, LLC DLP Conemaugh Memorial Medical UPMC Altoona DLP Conemaugh Miners Medical Conemaugh Physician Group Center, LLC Cresson PCP/NPI# 1205845724 Center, LLC Cura Family Medicine Sharon Regional Health System PCP/NPI# 1154588499 815 Second Street Heaton Family Practice LLC PCP/NPI# 1689080657 Cresson, PA 16630 917 Philadelphia Avenue Bedford Open to Existing Patients Only CHI Berkley Hills (814) 886-2911 Northern Cambria, PA 15714 111 Nason Drive 1 Tech Park Drive Member(s) (814) 948-2945 Suite 1130 Member(s) Family Practice Suite 103 Ratchford, Donald F., MD® Roaring Spring, PA 16673 Johnstown, PA 15901 Hospital Affiliation(s) Schettini Prasko, Debra A., DO® (814) 475-8700 PCP/NPI# 1265848600 (814) 224-2213 DLP Conemaugh Memorial Medical Hospital Affiliation(s) CHI Shoenthal Member(s) 318 Goucher Street Center, LLC DLP Conemaugh Memorial Medical 4186 Cortland Drive Heaton,
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