Individual provider Active NPI

Brittany Diane Vitale, PA - C

  • Physician Assistant
  • Pittsburgh, PA
National Provider Identifier
1295164283
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA056616 Issued in PA
Practice address
4815 Liberty Ave Ste 322
Pittsburgh, PA 15224-2156
Phone
(412) 578-4484
Fax
(412) 578-3536
NPI assigned
Nov 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA056616 PA Primary

Addresses

Primary practice location

4815 Liberty Ave Ste 322
Pittsburgh, PA 15224-2156

Mailing address

4815 Liberty Ave Ste 322
Pittsburgh, PA 15224-2156
Phone (412) 578-4484

Other identifiers 1

IdentifierTypeStateIssuer
103365830MedicaidPA

Other names 1

  • Brittany Diane Nock Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bvitale160585@direct.ahn.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140314000668 PA Practitioner - Physician Assistant 6608007604 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA056616PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Clinic CurrentSince Jun 23, 2018 Accepting new patients
Allegheny Clinic CurrentSince Jun 23, 2018 Accepting new patients
Allegheny Clinic Past Accepting new patients

Locations

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

4815 Liberty Ave
Ste GR70
Pittsburgh, PA 15224
Phone (412) 578-4484

320 E North Ave
Fl 4
Pittsburgh, PA 15212
Phone (412) 359-3319

4815 Liberty Ave
Ste 322
Pittsburgh, PA 15224
Phone (412) 330-2509

Interoperability endpoints

  • Direct secure messaging: bvitale160585@direct.ahn.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1384128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1295164283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 LIBERTY AVE STE 322",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152242156",
            "telephone_number": "412-578-4484",
            "fax_number": "412-578-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 LIBERTY AVE STE 322",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152242156",
            "telephone_number": "412-578-4484",
            "fax_number": "412-578-3536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITALE",
        "first_name": "BRITTANY",
        "middle_name": "DIANE",
        "credential": "PA - C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-11",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA056616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103365830",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bvitale160585@direct.ahn.org",
            "affiliation": "N",
            "address_1": "4815 Liberty Ave Ste 322",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152242156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BRITTANY",
            "last_name": "NOCK",
            "middle_name": "DIANE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.