NPIMap

Individual provider Active NPI

Albert Richard Fogle Sr., DO

  • Geriatric Medicine (Family Medicine) Physician
  • Pittsburgh, PA
National Provider Identifier
1306085972
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
OS017058 Issued in PA
Practice address
4727 Friendship Ave
Suite 200
Pittsburgh, PA 15224-1779
Phone
(412) 235-5810
Fax
(412) 235-5890
NPI assigned
Feb 5, 2009
Last updated
Nov 20, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X OS017058 PA Primary

Addresses

Primary practice location

4727 Friendship Ave
Suite 200
Pittsburgh, PA 15224-1779

Mailing address

4727 Friendship Ave
Suite 200
Pittsburgh, PA 15224-1779
Phone (412) 235-5810

Other identifiers 1

IdentifierTypeStateIssuer
1029134110001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140702001572 PA Practitioner - Family Practice 0345278719 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Personal Care Medical Associates, LLCGroup PAC ID 1456344084, 64 clinicians

Practice addresses (Care Compare)

2000 Cliffmine Rd
Suite 500
Pittsburgh, PA 15275-1053
Phone (878) 201-3312

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Physician Assistant

State licenses

LicenseStateTypeSpecialty
755WVMDRegistered Dietitian
2435WVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pcma Palliative Division LLC CurrentSince Jan 1, 2021 Accepting new patients
Personal Care Medical Associates LLC CurrentSince Dec 1, 2020 Accepting new patients
Pennwood Operating LLC Past Accepting new patients
Harmony Rehabilitation & Nursing LLC Past Accepting new patients
Preston Memorial Medical Group Past Accepting new patients
4R0, LLC Past Accepting new patients
Ahmed Husari, MD, Inc Past Accepting new patients
Southwestern Healthcare Operations LLC Past Accepting new patients

Locations

2000 Cliffmine Rd
Ste 500
Pittsburgh, PA 15275
Phone (724) 766-0025

500 N Lewis Run Rd
West Mifflin/Pleasant Hills, PA 15122
Phone (412) 466-0600

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1233792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447977600000",
    "number": "1306085972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4727 FRIENDSHIP AVE",
            "address_2": "SUITE 200",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152241779",
            "telephone_number": "412-235-5810",
            "fax_number": "412-235-5890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4727 FRIENDSHIP AVE",
            "address_2": "SUITE 200",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152241779",
            "telephone_number": "412-235-5810",
            "fax_number": "412-235-5890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGLE",
        "first_name": "ALBERT",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-05",
        "last_updated": "2015-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "PA",
            "license": "OS017058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029134110001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.