NPIMap

Individual provider Active NPI

Jared Carl Bovalino, D.O.

  • Family Medicine Physician
  • Carnegie, PA
National Provider Identifier
1114286747
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS016857 Issued in PA
Practice address
2375 Greentree Rd
Carnegie, PA 15106-4203
Phone
(412) 276-1560
Fax
(412) 276-5805
NPI assigned
May 16, 2012
Last updated
Jul 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS016857 PA Primary

Addresses

Primary practice location

2375 Greentree Rd
Carnegie, PA 15106-4203

Mailing address

701 Technology Dr Ste 150
Canonsburg, PA 15317-9531
Phone (412) 531-2902

Other identifiers 2

IdentifierTypeStateIssuer
1030072870002MedicaidPA
416271JFZOtherPAMEDICARE PROVIDER NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150622000318 PA Practitioner - Family Practice 5496072316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2375 Greentree Rd
Carnegie, PA 15106-4203
Phone (412) 276-1560

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS016857PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Primary Care Physicians, Inc. Family Medicine CurrentSince Jul 15, 2015 Accepting new patients
Preferred Primary Care Physicians, Inc. Family Medicine Current Accepting new patients
Preferred Primary Care Physicians CurrentSince Jul 15, 2015 Accepting new patients

Locations

701 Technology Dr
Ste 150
Canonsburg, PA 15317
Phone (412) 531-2902

2375 Greentree Rd
Carnegie, PA 15106
Phone (412) 276-1560

2375 Greentree Rd
Fl 2
Carnegie, PA 15106
Phone (412) 249-1663

1050 Bower Hill Rd
Ste 202
Pittsburgh, PA 15243
Phone (412) 572-6122

Interoperability endpoints

  • Direct secure messaging: jaredbovalinodo@preferred.medentdirect.com

Organizations & group practices 3

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

Hospital & facility affiliations 6

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": "1337126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1114286747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 TECHNOLOGY DR STE 150",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153179531",
            "telephone_number": "412-531-2902",
            "fax_number": "412-531-2948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 GREENTREE RD",
            "city": "CARNEGIE",
            "state": "PA",
            "postal_code": "151064203",
            "telephone_number": "412-276-1560",
            "fax_number": "412-276-5805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOVALINO",
        "first_name": "JARED",
        "middle_name": "CARL",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-16",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS016857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1030072870002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "416271JFZ",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carnegie, PA

Sources for this page

Verify at the official NPI Registry.