Organization Active NPI

Allegheny Clinic

Doing business as Colonial Clinic

  • Family Medicine Physician
  • Sarver, PA
National Provider Identifier
1003242140
Registry record updated Jun 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ALLEGHENY CLINIC
Doing business as
Colonial Clinic
Practice address
706 Ekastown Rd
Sarver, PA 16055-9724
Phone
(724) 353-1508
Fax
(724) 353-2040
NPI assigned
Sep 20, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Cecili R Jones
Title
Analyst
Phone
(412) 330-4813

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

706 Ekastown Rd
Sarver, PA 16055-9724

Mailing address

706 Ekastown Rd
Sarver, PA 16055-9724
Phone (724) 353-1508

Other identifiers 1

IdentifierTypeStateIssuer
100731714MedicaidPA

Other names 1

  • Colonial Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040310000602 PA Part B Supplier - Clinic/Group Practice 5395649586 Receives reassigned benefits from 3,418 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

4815 Liberty Ave
Ste GR25
Pittsburgh, PA 15224
Phone (855) 281-4463

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403654400000",
    "number": "1003242140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 EKASTOWN RD",
            "city": "SARVER",
            "state": "PA",
            "postal_code": "160559724",
            "telephone_number": "724-353-1508",
            "fax_number": "724-353-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 EKASTOWN RD",
            "city": "SARVER",
            "state": "PA",
            "postal_code": "160559724",
            "telephone_number": "724-353-1508",
            "fax_number": "724-353-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEGHENY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-20",
        "last_updated": "2014-06-25",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CECILI",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ANALYST",
        "authorized_official_telephone_number": "412-330-4813"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100731714",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colonial Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sarver, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.