Individual provider Active NPI

John H Gresh, PA-C

  • Surgical Physician Assistant
  • Pittsburgh, PA
National Provider Identifier
1164415972
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
MA000827L Issued in PA
Practice address
4815 Liberty Ave
Suite 448
Pittsburgh, PA 15224-2156
Phone
(412) 682-6800
Fax
(412) 682-2036
NPI assigned
Aug 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA000827L PA Primary

Addresses

Primary practice location

4815 Liberty Ave
Suite 448
Pittsburgh, PA 15224-2156

Mailing address

4815 Liberty Ave
Suite 448
Pittsburgh, PA 15224-2156
Phone (412) 682-6800

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180410002055 PA Order and Referring Only - Physician Assistant 8527099365

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA000827LPAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Health Network Past Accepting new patients
Oakland Neurosurgical Associates 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": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1164415972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 LIBERTY AVE",
            "address_2": "SUITE 448",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152242156",
            "telephone_number": "412-682-6800",
            "fax_number": "412-682-2036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 LIBERTY AVE",
            "address_2": "SUITE 448",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152242156",
            "telephone_number": "412-682-6800",
            "fax_number": "412-682-2036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRESH",
        "first_name": "JOHN",
        "middle_name": "H",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA000827L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.