Active NPI
Joseph L Sturdevant, MD
- Internal Medicine Physician
- Olean, NY
National Provider Identifier
1326081704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD428120
- Practice address
- 515 Main St
Olean, NY 14760-1513 - Phone
- (716) 373-2600
- NPI assigned
- Jun 14, 2006
- Last updated
- Oct 10, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD428120 | PA | Primary |
Addresses
Primary practice location
515 Main St
Olean, NY 14760-1513
Mailing address
PO Box 641057
Pittsburgh, PA 15264-1057
Phone (800) 655-2656
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 186463 | Other | PA | UNISON |
| 1069667 | Other | WV | W. VIRGINIA WORKERS COMP |
| 1015984860001 | Medicaid | PA | |
| 00027610101 | Other | PA | UNIVERA |
| 1333544 | Other | PA | AETNA |
| 411353 | Other | PA | UPMC |
| 02757308 | Other | NY | NY MEDICAL ASSISTANCE |
| 2655247 | Other | OH | OH MEDICAL ASSISTANCE |
| P00339483 | Other | PA | RR MEDICARE |
| 1552882 | Other | PA | GATEWAY |
| 1861235 | Other | PA | BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349827200000",
"number": "1326081704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 641057",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152641057",
"telephone_number": "800-655-2656",
"fax_number": "412-822-7411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 MAIN ST",
"city": "OLEAN",
"state": "NY",
"postal_code": "147601513",
"telephone_number": "716-373-2600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STURDEVANT",
"first_name": "JOSEPH",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-14",
"last_updated": "2012-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MD428120",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON",
"identifier": "186463",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "W. VIRGINIA WORKERS COMP",
"identifier": "1069667",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1015984860001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERA",
"identifier": "00027610101",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "1333544",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UPMC",
"identifier": "411353",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NY MEDICAL ASSISTANCE",
"identifier": "02757308",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OH MEDICAL ASSISTANCE",
"identifier": "2655247",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00339483",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY",
"identifier": "1552882",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "1861235",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Olean, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.