Individual provider Active NPI

Michael Robert Charley, MD

  • Internal Medicine Physician
  • Pittsburgh, PA
National Provider Identifier
1104164011
Registry record updated Jan 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD040066E Issued in PA
Practice address
530 Squaw Run Rd E
Pittsburgh, PA 15238-1922
Phone
(412) 963-7958
NPI assigned
Jan 28, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD040066E PA
Internal Medicine Physician 207R00000X MD040066E PA Primary

Addresses

Primary practice location

530 Squaw Run Rd E
Pittsburgh, PA 15238-1922

Mailing address

530 Squaw Run Rd E
Pittsburgh, PA 15238-1922
Phone (412) 963-7958

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD040066EPAMDDermatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1359331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359331200000",
    "number": "1104164011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 SQUAW RUN RD E",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152381922",
            "telephone_number": "412-963-7958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 SQUAW RUN RD E",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152381922",
            "telephone_number": "412-963-7958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLEY",
        "first_name": "MICHAEL",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-28",
        "last_updated": "2013-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD040066E",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD040066E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; 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.