NPIMap

Organization Active NPI

Upmc Community Medicine Inc

  • Surgery Physician
  • Everett, PA
National Provider Identifier
1164795654
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
UPMC COMMUNITY MEDICINE INC
Practice address
195 Memorial Dr
Suite 1
Everett, PA 15537-7056
Phone
(412) 647-7788
Fax
(412) 647-4050
NPI assigned
Feb 15, 2012
Last updated
Feb 15, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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

Authorized official

Name
Mr. Mark Ehalt
Title
Sr.Director
Phone
(412) 647-0943

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

195 Memorial Dr
Suite 1
Everett, PA 15537-7056

Mailing address

195 Memorial Dr
Suite 1
Everett, PA 15537-7056
Phone (412) 647-7788

Other names 1

  • UPMC BEDFORD GENERAL SURGERY Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040217000388 PA Part B Supplier - Clinic/Group Practice 2062318975 Receives reassigned benefits from 1,494 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Primecare Medical Assoc200 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329264000000",
    "number": "1164795654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 MEMORIAL DR",
            "address_2": "SUITE 1",
            "city": "EVERETT",
            "state": "PA",
            "postal_code": "155377056",
            "telephone_number": "412-647-7788",
            "fax_number": "412-647-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 MEMORIAL DR",
            "address_2": "SUITE 1",
            "city": "EVERETT",
            "state": "PA",
            "postal_code": "155377056",
            "telephone_number": "412-647-7788",
            "fax_number": "412-647-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPMC COMMUNITY MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-15",
        "last_updated": "2012-02-15",
        "status": "A",
        "authorized_official_last_name": "EHALT",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "SR.DIRECTOR",
        "authorized_official_telephone_number": "412-647-0943",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UPMC BEDFORD GENERAL SURGERY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Everett, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.