NPIMap

Organization Active NPI

Premier Medical Associates, PC

  • Ophthalmology Physician
  • Pittsburgh, PA
National Provider Identifier
1255716262
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD039248E Issued in PA
Legal business name
PREMIER MEDICAL ASSOCIATES, PC
Practice address
2140 Ardmore Blvd
Ste 150
Pittsburgh, PA 15221-4860
Phone
(412) 271-2400
Fax
(412) 271-0162
NPI assigned
Jul 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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

Authorized official

Name
Mr. Mark Derubeis
Title
Ceo
Phone
(412) 457-0060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X MD039248E PA Primary

Addresses

Primary practice location

2140 Ardmore Blvd
Ste 150
Pittsburgh, PA 15221-4860

Mailing address

3824 Northern Pike
Ste 700
Monroeville, PA 15146-2141
Phone (412) 457-0060

Other identifiers 1

IdentifierTypeStateIssuer
1007504600079MedicaidPA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469404800000",
    "number": "1255716262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3824 NORTHERN PIKE",
            "address_2": "STE 700",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462141",
            "telephone_number": "412-457-0060",
            "fax_number": "412-457-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 ARDMORE BLVD",
            "address_2": "STE 150",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152214860",
            "telephone_number": "412-271-2400",
            "fax_number": "412-271-0162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-21",
        "last_updated": "2016-07-25",
        "status": "A",
        "authorized_official_last_name": "DERUBEIS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "412-457-0060",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD039248E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007504600079",
            "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 Jul 25, 2016; 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.