Organization Active NPI

Upmc Community Medicine Inc

  • Internal Medicine Physician
  • Mars, PA
National Provider Identifier
1306070503
Registry record updated May 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
UPMC COMMUNITY MEDICINE INC
Practice address
123 Grand Avenue
Mars, PA 16046
Phone
(724) 625-3171
Fax
(412) 647-0943
NPI assigned
May 4, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2009

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

Authorized official

Name
Mr. Mark Ehalt
Title
Director
Phone
(412) 647-0943

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

123 Grand Avenue
Mars, PA 16046

Mailing address

123 Grand Avenue
Mars, PA 16046
Phone (724) 625-3171

Other names 1

  • Mars Medical Center-UPMC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040217000388 PA Part B Supplier - Clinic/Group Practice 2062318975 Receives reassigned benefits from 1,494 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

5140 Liberty Ave
Ste 150
Pittsburgh, PA 15224
Phone (412) 315-0400

Practitioners & affiliated clinicians

Practitioners 9

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": "1241395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241395200000",
    "number": "1306070503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 GRAND AVENUE",
            "city": "MARS",
            "state": "PA",
            "postal_code": "16046",
            "telephone_number": "724-625-3171",
            "fax_number": "412-647-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 GRAND AVENUE",
            "city": "MARS",
            "state": "PA",
            "postal_code": "16046",
            "telephone_number": "724-625-3171",
            "fax_number": "412-647-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPMC COMMUNITY MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-04",
        "last_updated": "2009-05-04",
        "status": "A",
        "authorized_official_last_name": "EHALT",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "412-647-0943",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mars Medical Center-UPMC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mars, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2009; 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.