Organization Active NPI

Allegheny Clinic

Doing business as Green Tree Medical Associates

  • Internal Medicine Physician
  • Pittsburgh, PA
National Provider Identifier
1134555113
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ALLEGHENY CLINIC
Doing business as
Green Tree Medical Associates
Practice address
651 Holiday Dr
Pittsburgh, PA 15220-2740
Phone
(412) 922-8490
Fax
(412) 921-1194
NPI assigned
Sep 23, 2013
Last updated
Nov 6, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Authorized official

Name
Cindy Waltemire
Title
Provider Enrollment Specialist
Phone
(412) 330-5864

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

651 Holiday Dr
Pittsburgh, PA 15220-2740

Mailing address

4 Allegheny Ctr FL 7
Pittsburgh, PA 15212-5255
Phone (412) 330-5861

Other identifiers 1

IdentifierTypeStateIssuer
100731714MedicaidPA

Other names 1

  • Green Tree Medical Associates Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.ahn.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040310000602 PA Part B Supplier - Clinic/Group Practice 5395649586 Receives reassigned benefits from 3,418 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1379894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604620800000",
    "number": "1134555113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ALLEGHENY CTR FL 7",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152125255",
            "telephone_number": "412-330-5861",
            "fax_number": "412-330-5844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 HOLIDAY DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152202740",
            "telephone_number": "412-922-8490",
            "fax_number": "412-921-1194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEGHENY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-23",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A",
        "authorized_official_last_name": "WALTEMIRE",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "412-330-5864"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100731714",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.ahn.org",
            "affiliation": "N",
            "address_1": "651 Holiday Dr",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152202740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Green Tree Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Green Tree Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 6, 2020; 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.