Individual provider Active NPI

Michael Allen Packard, D.O.

  • Diagnostic Radiology Physician
  • Pittsburgh, PA
National Provider Identifier
1073841615
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
OS015976 Issued in PA
Practice address
320 E North Ave
Pittsburgh, PA 15212-4756
Phone
(412) 359-2459
Fax
(414) 359-8233
NPI assigned
Nov 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X OT012102 PA
Diagnostic Radiology Physician 2085R0202X OS015976 PA Primary

Addresses

Primary practice location

320 E North Ave
Pittsburgh, PA 15212-4756

Mailing address

320 E North Ave
Pittsburgh, PA 15212-4756
Phone (412) 359-2459

Other practice location 1

301 Ohio River Blvd Ste 301
Sewickley, PA 15143-1300
Phone (412) 741-6530

Other practice location 2

200 Lothrop St
Pittsburgh, PA 15213-2536
Phone (412) 647-7338

Other identifiers 1

IdentifierTypeStateIssuer
102725126MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mpackard201956@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120614000453 PA Practitioner - Diagnostic Radiology 0941464390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allegheny Clinic RadiologyGroup PAC ID 8426364738, 153 clinicians

Practice addresses (Care Compare)

320 E N Ave
Pittsburgh, PA 15212-4756
Phone (412) 359-2459

Hospital & facility affiliations

  • Saint Vincent Hospital Hospital, Erie, PA, CCN 390009
  • Forbes Hospital Hospital, Monroeville, PA, CCN 390267
  • Allegheny General Hospital Hospital, Pittsburgh, PA, CCN 390050
  • Allegheny Valley Hospital Hospital, Natrona, PA, CCN 390032

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OT012102PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Clinic Radiology Diagnostic Radiology CurrentSince Dec 25, 2018 Accepting new patients
Radiologic Consultants, LTD Diagnostic Radiology Past Accepting new patients

Locations

320 E North Ave
Pittsburgh, PA 15212
Phone (412) 359-3131

100 S Jackson Ave
Pittsburgh, PA 15202
Phone (412) 734-6030

320 E North Ave
Ste G70
Pittsburgh, PA 15212

600 Aberdeen Dr
#B
Somerset, PA 15501

Interoperability endpoints

  • Direct secure messaging: mpackard@direct.excelahealth.org

Organizations & group practices 2

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1258588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1073841615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E NORTH AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124756",
            "telephone_number": "412-359-2459",
            "fax_number": "412-359-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E NORTH AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124756",
            "telephone_number": "412-359-2459",
            "fax_number": "414-359-8233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Ohio River Blvd Ste 301",
            "address_purpose": "LOCATION",
            "city": "Sewickley",
            "state": "PA",
            "postal_code": "151431300",
            "country_code": "US",
            "telephone_number": "412-741-6530",
            "fax_number": "412-741-9274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Lothrop St",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152132536",
            "country_code": "US",
            "telephone_number": "412-647-7338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACKARD",
        "first_name": "MICHAEL",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-19",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "OT012102",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "OS015976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102725126",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpackard201956@direct.ahn.org",
            "affiliation": "N",
            "address_1": "320 E North Ave",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152124756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.