NPIMap

Organization Active NPI

Heritage Valley Multispecialty Group, Inc

  • Orthopaedic Surgery Physician
  • Beaver, PA
National Provider Identifier
1073089918
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
HERITAGE VALLEY MULTISPECIALTY GROUP, INC
Practice address
1030 Beaner Hollow Rd
Beaver, PA 15009-9723
Phone
(724) 775-4242
NPI assigned
Oct 18, 2018
Last updated
Jul 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary
Orthopaedic Surgery of the Spine Physician 207XS0117X NU
Foot & Ankle Surgery Podiatrist 213ES0103X NU

Addresses

Primary practice location

1030 Beaner Hollow Rd
Beaver, PA 15009-9723

Mailing address

2 Peartree Way
Beaver, PA 15009-1954
Phone (724) 773-6802

Other identifiers 2

IdentifierTypeStateIssuer
0015654460093MedicaidPA
0015654460092MedicaidPA

Other names 1

  • Heritage Valley Medical Group, Inc. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040220000870 PA Part B Supplier - Clinic/Group Practice 0042105678 Receives reassigned benefits from 288 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Coraopolis, PA; Beaver Falls, PA; Cranberry TWP, PA; Ellwood City, PA; Imperial, PA; Leetsdale, PA; MC Kees Rocks, PA; McKees Rocks, PA…

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1030 Beaner Hollow Rd
Beaver, PA 15009
Phone (724) 774-0778

2201 Park Manor Blvd
Ste 100
Pittsburgh, PA 15205
Phone (412) 749-6920

2201 Park Manor Blvd
Ste 200
Pittsburgh, PA 15205
Phone (724) 773-8950

Practitioners & affiliated clinicians

Practitioners 79

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 79

NPI Registry JSON

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1073089918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PEARTREE WAY",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "150091954",
            "telephone_number": "724-773-6802",
            "fax_number": "724-770-7919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 BEANER HOLLOW RD",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "150099723",
            "telephone_number": "724-775-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE VALLEY MULTISPECIALTY GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-18",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "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": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015654460093",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015654460092",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Valley Medical Group, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Beaver, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.