Organization Active NPI

Premier Med Rehab Inc

  • Physical Medicine & Rehabilitation Physician
  • Pittsburgh, PA
National Provider Identifier
1255511978
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
062181L Issued in PA
Legal business name
PREMIER MED REHAB INC
Practice address
4810 Liberty Avenue
Suite 1000
Pittsburgh, PA 15224-2108
Phone
(412) 918-2408
Fax
(412) 918-2411
NPI assigned
Nov 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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

Authorized official

Name
Mrs. Jamuna Sivakanthan, MDNPI 1346242492
Title
Physician Owner
Phone
(412) 918-2408

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 062181L PA Primary

Addresses

Primary practice location

4810 Liberty Avenue
Suite 1000
Pittsburgh, PA 15224-2108

Mailing address

4810 Liberty Avenue
Suite 1000
Pittsburgh, PA 15224-2108
Phone (412) 918-2408

Other identifiers 1

IdentifierTypeStateIssuer
1702643MedicaidPA

National Provider Directory

National Provider Directory

Locations

4810 Liberty Ave
Ste 1000
Pittsburgh, PA 15224
Phone (412) 918-2408

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196121600000",
    "number": "1255511978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4810 LIBERTY AVENUE",
            "address_2": "SUITE 1000",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152242108",
            "telephone_number": "412-918-2408",
            "fax_number": "412-918-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4810 LIBERTY AVENUE",
            "address_2": "SUITE 1000",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152242108",
            "telephone_number": "412-918-2408",
            "fax_number": "412-918-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MED REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2007-11-27",
        "status": "A",
        "authorized_official_last_name": "SIVAKANTHAN",
        "authorized_official_first_name": "JAMUNA",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "412-918-2408",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "062181L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1702643",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.