NPIMap

Organization Active NPI

Glade Run Medical Associates, Inc.

  • Surgery Physician
  • Kittanning, PA
National Provider Identifier
1114403037
Registry record updated Jul 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
GLADE RUN MEDICAL ASSOCIATES, INC.
Practice address
1 Nolte Dr
Kittanning, PA 16201-7111
Phone
(724) 545-3588
Fax
(724) 545-3589
NPI assigned
Jul 13, 2018
Last updated
Jul 13, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2018

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

Authorized official

Name
Pamela J Milsom
Title
Director
Phone
(724) 543-8670

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Primary

Addresses

Primary practice location

1 Nolte Dr
Kittanning, PA 16201-7111

Mailing address

700 Medical Arts BLDG Ste 710
Kittanning, PA 16201-7141
Phone (724) 543-8626

Other names 1

  • Armstrong Breast and Surgical Services Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100806000006 PA Part B Supplier - Clinic/Group Practice 3577696897 Receives reassigned benefits from 40 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kittanning, PA; Sarver, PA; New Bethlehem, PA; Natrona Heights, PA

Other NPIs on the same Medicare enrollment 25

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

View all 25

National Provider Directory

National Provider Directory

Locations

600 Medical Arts Bldg
Ste 620
Kittanning, PA 16201
Phone (724) 545-6673

Practitioners & affiliated clinicians

Practitioners 1

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.

  • Richard A Bernat, MD
    • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
    • Pittsburgh, PA
    • NPI 1447218649
    NPD

NPI Registry JSON

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

{
    "created_epoch": "1531440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531440000000",
    "number": "1114403037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 MEDICAL ARTS BLDG STE 710",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162017141",
            "telephone_number": "724-543-8626",
            "fax_number": "724-543-8736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 NOLTE DR",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162017111",
            "telephone_number": "724-545-3588",
            "fax_number": "724-545-3589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLADE RUN MEDICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-13",
        "last_updated": "2018-07-13",
        "status": "A",
        "authorized_official_last_name": "MILSOM",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "724-543-8670"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Armstrong Breast and Surgical Services",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Armstrong Breast and Surgical Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kittanning, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; 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.