NPIMap

Organization Active NPI

Heritage Valleymedical Group, Inc.

  • Family Medicine Physician
  • Beaver, PA
National Provider Identifier
1073765673
Registry record updated Jun 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HERITAGE VALLEYMEDICAL GROUP, INC.
Practice address
246 Friendship Cir
Beaver, PA 15009-9713
Phone
(724) 773-5207
NPI assigned
Oct 15, 2008
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Norman F. Mitry
Title
President & Ceo
Phone
(724) 773-4776

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Corporate family (same tax ID) 16

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

National Provider Directory

National Provider Directory
Tax ID family
Tri - State Medical Group Inc (92 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

246 Friendship Cir
Beaver, PA 15009-9713

Mailing address

246 Friendship Cir
Beaver, PA 15009-9713
Phone (724) 773-5207

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
0202677MedicaidOH
0015654460023MedicaidPA

Other names 1

NPPES NPI Registry
  • HVMG Les T. Pallone D.O. Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 29, 2012.

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340928000000",
    "number": "1073765673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 FRIENDSHIP CIR",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "150099713",
            "telephone_number": "724-773-5207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 FRIENDSHIP CIR",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "150099713",
            "telephone_number": "724-773-5207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE VALLEYMEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-15",
        "last_updated": "2012-06-29",
        "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"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0202677",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015654460023",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HVMG Les T. Pallone D.O.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 29, 2012; 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.