Organization Active NPI

Plastic Surgical Associates of Pittsburgh, P.C.

  • Plastic Surgery Physician
  • Pittsburgh, PA
National Provider Identifier
1023060779
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
PLASTIC SURGICAL ASSOCIATES OF PITTSBURGH, P.C.
Practice address
1050 Bower Hill Rd
Suite 105
Pittsburgh, PA 15243-1800
Phone
(412) 572-6164
Fax
(412) 572-6156
NPI assigned
May 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2016

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

Authorized official

Name
Dr. Robert W Bragdon, MD
Title
President
Phone
(412) 572-6164

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

1050 Bower Hill Rd
Suite 105
Pittsburgh, PA 15243-1800

Mailing address

PO Box 719
Monroeville, PA 15146-0719
Phone (412) 457-0175

Other identifiers 1

IdentifierTypeStateIssuer
1015516860001MedicaidPA

Other names 1

  • Bragdon-Stofman Plastic Surgery Group PC Former legal business name

National Provider Directory

National Provider Directory

Locations

1350 Locust St
Ste G103
Pittsburgh, PA 15219
Phone (412) 232-5616

125 Warrendale Bayne Rd
Ste 150
Warrendale, PA 15086
Phone (412) 232-5616

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455753600000",
    "number": "1023060779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 719",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151460719",
            "telephone_number": "412-457-0175",
            "fax_number": "412-457-0179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 BOWER HILL RD",
            "address_2": "SUITE 105",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152431800",
            "telephone_number": "412-572-6164",
            "fax_number": "412-572-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGICAL ASSOCIATES OF PITTSBURGH, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2016-02-18",
        "status": "A",
        "authorized_official_last_name": "BRAGDON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "412-572-6164",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1015516860001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bragdon-Stofman Plastic Surgery Group PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Feb 18, 2016; 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.