NPIMap

Organization Active NPI

Sangodeyi Surgical Clinic P.C.

  • Surgery Physician
  • Coraopolis, PA
National Provider Identifier
1306989603
Registry record updated Sep 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SANGODEYI SURGICAL CLINIC P.C.
Practice address
935 Thorn Run Rd
Suite W201
Coraopolis, PA 15108-2861
Phone
(412) 269-9665
Fax
(412) 269-7985
NPI assigned
Feb 15, 2007
Last updated
Sep 27, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2007

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

Authorized official

Name
Dr. Olu R Sangodeyi, M.D.
Title
President
Phone
(412) 269-9665

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

935 Thorn Run Rd
Suite W201
Coraopolis, PA 15108-2861

Mailing address

935 Thorn Run Rd
Suite W201
Coraopolis, PA 15108-2861
Phone (412) 269-9665

Other identifiers 1

IdentifierTypeStateIssuer
001961556-0002OtherPAPROMISE NUMBER

National Provider Directory

National Provider Directory

Locations

935 Thorn Run Rd
Ste 201
Moon Twp, PA 15108
Phone (412) 269-9665

935 Thorn Run Rd
Ste W201
Moon Twp, PA 15108
Phone (412) 269-9665

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190851200000",
    "number": "1306989603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 THORN RUN RD",
            "address_2": "SUITE W201",
            "city": "CORAOPOLIS",
            "state": "PA",
            "postal_code": "151082861",
            "telephone_number": "412-269-9665",
            "fax_number": "412-269-7985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 THORN RUN RD",
            "address_2": "SUITE W201",
            "city": "CORAOPOLIS",
            "state": "PA",
            "postal_code": "151082861",
            "telephone_number": "412-269-9665",
            "fax_number": "412-269-7985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANGODEYI SURGICAL CLINIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-09-27",
        "status": "A",
        "authorized_official_last_name": "SANGODEYI",
        "authorized_official_first_name": "OLU",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "412-269-9665",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROMISE NUMBER",
            "identifier": "001961556-0002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coraopolis, PA

Sources for this page

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