Individual provider Active NPI

Gerald David Klug, MD

  • Specialist
  • Pittsburgh, PA
National Provider Identifier
1124047816
Registry record updated Dec 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD032913-E Issued in PA
Practice address
3528 Blvd of the Allies
Pittsburgh, PA 15213-4355
Phone
(412) 681-1406
Fax
(412) 681-1408
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD032913-E PA Primary

Addresses

Primary practice location

3528 Blvd of the Allies
Pittsburgh, PA 15213-4355

Mailing address

109 Pine Acres LN
Coraopolis, PA 15108-2968
Phone (412) 225-9054

Other identifiers 1

IdentifierTypeStateIssuer
0010269410001MedicaidPA

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
I20051019000864 PA Practitioner - Internal Medicine 4981620911 Practice locations: Coraopolis, PA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD032913-EPAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
John C Phillips MD LLC Past Accepting new patients
Jalit Tuchinda M.D., PC Specialist Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545350400000",
    "number": "1124047816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 PINE ACRES LN",
            "city": "CORAOPOLIS",
            "state": "PA",
            "postal_code": "151082968",
            "telephone_number": "412-225-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3528 BLVD OF THE ALLIES",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152134355",
            "telephone_number": "412-681-1406",
            "fax_number": "412-681-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUG",
        "first_name": "GERALD",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2018-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD032913-E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010269410001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.