Individual provider Active NPI

Nicholaus E Barbosa, M.D, D.M.D

  • Oral and Maxillofacial Surgery (Dentist)
  • Pittsburgh, PA
National Provider Identifier
1215375803
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS038482 Issued in PA
Practice address
320 E North Ave
Pittsburgh, PA 15212-4756
Phone
(617) 869-4935
NPI assigned
Jun 5, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS038482 PA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS038482 PA Primary

Addresses

Primary practice location

320 E North Ave
Pittsburgh, PA 15212-4756

Mailing address

320 E North Ave
Pittsburgh, PA 15212-4756
Phone (617) 869-4935

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
I20161004001146 PA Practitioner - Maxillofacial Surgery 7911295142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
Boston Univ Goldman School of Dental Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dattilo and Hall LLCGroup PAC ID 7810989886, 4 clinicians

Practice addresses (Care Compare)

305 Mount Lebanon Blvd
Suite 305
Pittsburgh, PA 15234-1511
Phone (412) 563-7707

Hospital & facility affiliations

  • Allegheny General Hospital Hospital, Pittsburgh, PA, CCN 390050

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Organizations & group practices 1

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1370390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1215375803",
    "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": "617-869-4935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E NORTH AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124756",
            "telephone_number": "617-869-4935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARBOSA",
        "first_name": "NICHOLAUS",
        "middle_name": "E",
        "credential": "M.D, D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-05",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS038482",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS038482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.