Organization Active NPI

Elevated Oral & Implant Surgery, P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Upper St Clair, PA
National Provider Identifier
1053861799
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
ELEVATED ORAL & IMPLANT SURGERY, P.C.
Practice address
1131 Boyce Rd
Suite a
Upper St Clair, PA 15241-3927
Phone
(724) 260-5009
Fax
(724) 299-3154
NPI assigned
Oct 5, 2016
Last updated
Apr 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Authorized official

Name
Dr. Meghan Deisroth Barroner, D.M.D.NPI 1366670556
Title
President, Owner
Phone
(724) 260-5009

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X Primary
Anesthesiology Physician 207L00000X

Addresses

Primary practice location

1131 Boyce Rd
Suite a
Upper St Clair, PA 15241-3927

Mailing address

1131 Boyce Rd
Suite a
Upper St Clair, PA 15241-3927
Phone (724) 260-5009

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170310000447 PA Part B Supplier - Clinic/Group Practice 4789968793 Receives reassigned benefits from 2 practitioners
Practice locations: Pittsburgh, PA

National Provider Directory

National Provider Directory

Locations

1131 Boyce Rd
Ste A
Upper St Clair, PA 15241
Phone (724) 260-5009

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712188800000",
    "number": "1053861799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 BOYCE RD",
            "address_2": "SUITE A",
            "city": "UPPER ST CLAIR",
            "state": "PA",
            "postal_code": "152413927",
            "telephone_number": "724-260-5009",
            "fax_number": "724-299-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 BOYCE RD",
            "address_2": "SUITE A",
            "city": "UPPER ST CLAIR",
            "state": "PA",
            "postal_code": "152413927",
            "telephone_number": "724-260-5009",
            "fax_number": "724-299-3154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATED ORAL & IMPLANT SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-05",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A",
        "authorized_official_last_name": "BARRONER",
        "authorized_official_first_name": "MEGHAN",
        "authorized_official_middle_name": "DEISROTH",
        "authorized_official_title_or_position": "PRESIDENT, OWNER",
        "authorized_official_telephone_number": "724-260-5009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper St Clair, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.