NPIMap

Organization Active NPI

Primary Care Health Services Inc.

Doing business as West End Health Center

  • Federally Qualified Health Center (FQHC)
  • Pittsburgh, PA
National Provider Identifier
1003986498
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PRIMARY CARE HEALTH SERVICES INC.
Doing business as
West End Health Center
Practice address
415 Neptune St
Pittsburgh, PA 15220-5516
Phone
(412) 921-7200
Fax
(412) 921-4681
NPI assigned
Nov 9, 2006
Last updated
Sep 29, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
PRIMARY CARE HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Authorized official

Name
Mr. Wilford A. Payne
Title
Executive Director
Phone
(412) 244-4700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

415 Neptune St
Pittsburgh, PA 15220-5516

Mailing address

7227 Hamilton Ave
Pittsburgh, PA 15208-1814
Phone (412) 244-4700

Other names 1

  • West End Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101124001101 PA Part A Provider - Federally Qualified Health Center (FQHC) 7012825722 Practice locations: Pittsburgh, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003986498. Details of each certification follow.

Federally qualified health center certification: CCN 391842

Legal name
PRIMARY CARE HEALTH SERVICES, INC.
Doing business as
ALMA ILLERY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 1, 1991
Last certification
Nov 1, 1991
Ownership / control type
Non-profit – other
Organization structure
CorporationNon-profit
Incorporated
Mar 1, 1977 in PA
Enrollment address
415 Neptune St
Pittsburgh, PA 15220-5516

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0912774West End Health Center415 Neptune St, Pittsburgh, PA 15220Provider-performed microscopyMar 11, 2028

National Provider Directory

National Provider Directory
Tax ID family
Manchester HLTH Ctr Med16 organizations share this tax ID, including this one
Part of
Manchester HLTH Ctr Med

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

807 Wallace Ave
Ste 203
Pittsburgh, PA 15221
Phone (412) 247-5216

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ronald Thornhill Individual Corporate Director Sep 27, 2010
Tawnya R. Farris Individual Corporate Director Sep 27, 2010
Carolyn Vera Callahan Individual Corporate Director Sep 27, 2010
John Hollis Individual W-2 Managing Employee Apr 1, 2019
Operational/Managerial Control Sep 1, 2019
Judith Ginyard Individual Corporate Director Sep 27, 2010
Lea Blumenfeld Individual Corporate Director Sep 27, 2010
Jerome E Gloster Individual Corporate OfficerCeo Apr 1, 2019
W-2 Managing Employee Apr 1, 2019
Richard M. Adams Individual Corporate Director Nov 29, 2010
Eric Younkins Individual Corporate Director Sep 27, 2010

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317254400000",
    "number": "1003986498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 HAMILTON AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152081814",
            "telephone_number": "412-244-4700",
            "fax_number": "412-244-4992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 NEPTUNE ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152205516",
            "telephone_number": "412-921-7200",
            "fax_number": "412-921-4681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE HEALTH SERVICES INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIMARY CARE HEALTH SERVICES, INC.",
        "enumeration_date": "2006-11-09",
        "last_updated": "2011-09-29",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "WILFORD",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "412-244-4700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West End Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.