Individual provider Active NPI

Gustav R Eles, DO

  • Cardiovascular Disease Physician
  • Coraopolis, PA
National Provider Identifier
1063474435
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
OS005112L Issued in PA
Practice address
995 Beaver Grade Road
Suite B
Coraopolis, PA 15108-2766
Phone
(412) 264-9500
Fax
(412) 264-8999
NPI assigned
Apr 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X OS005112L PA Primary

Addresses

Primary practice location

995 Beaver Grade Road
Suite B
Coraopolis, PA 15108-2766

Mailing address

995 Beaver Grade Rd Ste B2
Coraopolis, PA 15108-2766
Phone (412) 264-9500

Other identifiers 5

IdentifierTypeStateIssuer
3810017484MedicaidWV
1079909MedicaidPA
1605UOtherNCBCBSNC
2195413MedicaidOH
0010799090027MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address geles21451@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
OS005112LPAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Son-X Imaging, Inc. Cardiovascular Disease PastSince Dec 1, 1998 Accepting new patients
Indiana Healthcare Physician Services Inc Cardiovascular Disease PastSince Jun 1, 2010 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Pittsburgh Cardiac & Vascular Associates PC Cardiovascular Disease PastSince Jun 30, 1997 Accepting new patients
West Penn Allegheny Health System Inc. Past Accepting new patients
Allegheny Clinic Past Accepting new patients

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1063474435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 BEAVER GRADE RD STE B2",
            "city": "CORAOPOLIS",
            "state": "PA",
            "postal_code": "151082766",
            "telephone_number": "412-264-9500",
            "fax_number": "412-264-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 BEAVER GRADE ROAD",
            "address_2": "SUITE B",
            "city": "CORAOPOLIS",
            "state": "PA",
            "postal_code": "151082766",
            "telephone_number": "412-264-9500",
            "fax_number": "412-264-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELES",
        "first_name": "GUSTAV",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "OS005112L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810017484",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1079909",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "1605U",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2195413",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010799090027",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "geles21451@direct.ahn.org",
            "affiliation": "N",
            "address_1": "995 Beaver Grade Road",
            "address_2": "Suite B",
            "city": "Coraopolis",
            "state": "PA",
            "country_code": "US",
            "postal_code": "151082766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coraopolis, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; 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.