NPIMap

Organization Active NPI

Heritage Valley Multispecialty Group, Inc.

  • Family Medicine Physician
  • Pittsburgh, PA
National Provider Identifier
1003564113
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HERITAGE VALLEY MULTISPECIALTY GROUP, INC.
Practice address
2201 Park Manor Blvd
Pittsburgh, PA 15205-4819
Phone
(412) 749-6920
Fax
(412) 749-6779
NPI assigned
Mar 17, 2022
Organization subpart
Yes
Parent organization
HERITAGE VALLEY MULTISPECIALTY GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Authorized official

Name
Mr. Norman F Mitry
Title
President & Ceo
Phone
(724) 773-4776

Specialties & licenses 1

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

Addresses

Primary practice location

2201 Park Manor Blvd
Pittsburgh, PA 15205-4819

Mailing address

2201 Park Manor Blvd
Pittsburgh, PA 15205-4819
Phone (412) 749-6920

Other identifiers 1

IdentifierTypeStateIssuer
0015654460117MedicaidPA

Other names 1

  • HVMG Park Manor Medical Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Tri - State Medical Group Inc92 organizations share this tax ID, including this one
Part of
Tri - State Medical Group Inc

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1647475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647475200000",
    "number": "1003564113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 PARK MANOR BLVD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152054819",
            "telephone_number": "412-749-6920",
            "fax_number": "412-749-6779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 PARK MANOR BLVD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152054819",
            "telephone_number": "412-749-6920",
            "fax_number": "412-749-6779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE VALLEY MULTISPECIALTY GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HERITAGE VALLEY MULTISPECIALTY GROUP, INC.",
        "enumeration_date": "2022-03-17",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-04",
        "status": "A",
        "authorized_official_last_name": "MITRY",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "724-773-4776",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "0015654460117",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HVMG Park Manor Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.