Rudolph Antoncic III, M.D., P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD418006 Issued in PA

Legal business name

RUDOLPH ANTONCIC III, M.D., P.C.

Practice address

5301 Walnut St
McKeesport, PA 15132-6327

Phone

(412) 751-4400

Fax

(412) 751-4881

NPI assigned

Jul 5, 2007

Last updated

Oct 25, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Rudolph Andrew Antoncic III, M.D.NPI 1871667907

Title

Owner

Phone

(412) 754-3770

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11447/brand/1/csg/1/fhir/r4

Practitioners 1

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.

• Rudolph A Antoncic III, MD

  • Internal Medicine Physician
  • McKeesport, PA
  • NPI 1871667907
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1225236722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 GREENOCK BUENA VISTA RD",
            "city": "MCKEESPORT",
            "state": "PA",
            "postal_code": "151353007",
            "telephone_number": "412-754-3770",
            "fax_number": "412-896-0627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 WALNUT ST",
            "city": "MCKEESPORT",
            "state": "PA",
            "postal_code": "151326327",
            "telephone_number": "412-751-4400",
            "fax_number": "412-751-4881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUDOLPH ANTONCIC III, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-05",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "ANTONCIC",
        "authorized_official_first_name": "RUDOLPH",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "412-754-3770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD418006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1385401",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019003720001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HEALTH PLAN",
            "identifier": "1521997",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE",
            "identifier": "2074615000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON HEALTH PLAN",
            "identifier": "125036",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA",
            "identifier": "262531",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC HEALTH PLAN",
            "identifier": "308210",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "75640",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Rothenberg
• Julie Roudybush, NP
• Maxwell Dylan Rourke, PTA
• Jordan Paul Rouzer, PT
• Dino W Rovito
• Gina M Rullo, RN
• James Steve Rulyak, R.PH.
• Danielle Rura
• Jessica Rybar
• Gerald L Sabatini

• Internal Medicine Physician in McKeesport, PA
• Providers in McKeesport, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.