NPIMap

Organization Active NPI

West Penn Allegheny Health System Inc.

Doing business as Allegheny General Hospital St. Mary's Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Saint Marys, PA
National Provider Identifier
1174539704
Registry record updated Jun 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
530101 Issued in PA
Legal business name
WEST PENN ALLEGHENY HEALTH SYSTEM INC.
Doing business as
Allegheny General Hospital St. Mary's Dialysis Center
Practice address
763 Johnsonburg Rd
Saint Marys, PA 15857-3417
Phone
(814) 834-5181
Fax
(814) 834-5182
NPI assigned
Aug 1, 2006
Last updated
Jun 1, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
WEST PENN ALLEGHENY HEALTH SYSTEM INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 1, 2012

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

Authorized official

Name
Mr. Rick Fries
Title
Interim VP Finance
Phone
(412) 359-8550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 530101 PA Primary

Addresses

Primary practice location

763 Johnsonburg Rd
Saint Marys, PA 15857-3417

Mailing address

320 E North Ave
Pittsburgh, PA 15212-4756
Phone (412) 359-3131

Other identifiers 2

IdentifierTypeStateIssuer
1007508630045MedicaidPA
1007277200099MedicaidPA

Other names 1

  • Allegheny General Hospital St. Mary's Dialysis Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Allegheny General Hospi17 organizations share this tax ID, including this one
Part of
West Penn Neuro I

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338508800000",
    "number": "1174539704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E NORTH AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124756",
            "telephone_number": "412-359-3131",
            "fax_number": "412-359-4108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 JOHNSONBURG RD",
            "city": "SAINT MARYS",
            "state": "PA",
            "postal_code": "158573417",
            "telephone_number": "814-834-5181",
            "fax_number": "814-834-5182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST PENN ALLEGHENY HEALTH SYSTEM INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST PENN ALLEGHENY HEALTH SYSTEM INC.",
        "enumeration_date": "2006-08-01",
        "last_updated": "2012-06-01",
        "status": "A",
        "authorized_official_last_name": "FRIES",
        "authorized_official_first_name": "RICK",
        "authorized_official_title_or_position": "INTERIM VP FINANCE",
        "authorized_official_telephone_number": "412-359-8550",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "PA",
            "license": "530101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007508630045",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007277200099",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allegheny General Hospital St. Mary's Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Marys, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.