Organization Active NPI

Mitre Gastroenterology Associates

  • Gastroenterology Physician
  • Pittsburgh, PA
National Provider Identifier
1366487720
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD032806L Issued in NJ
Legal business name
MITRE GASTROENTEROLOGY ASSOCIATES
Practice address
925 Brighton Rd
Pittsburgh, PA 15233-1707
Phone
(412) 321-1648
Fax
(412) 321-4216
NPI assigned
Jun 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ricardo Mitre, M.D.NPI 1932130556
Title
Medical Director
Phone
(412) 321-1648

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X MD032806L NJ Primary

Addresses

Primary practice location

925 Brighton Rd
Pittsburgh, PA 15233-1707

Mailing address

925 Brighton Rd
Pittsburgh, PA 15233-1707
Phone (412) 321-1648

Other identifiers 2

IdentifierTypeStateIssuer
1009520810001MedicaidNJ
1568734OtherNJBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

320 Fort Duquesne Blvd
Ste 370
Pittsburgh, PA 15222
Phone (412) 391-1690

Practitioners & affiliated clinicians

Practitioners 2

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": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366487720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 BRIGHTON RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152331707",
            "telephone_number": "412-321-1648",
            "fax_number": "412-321-4216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 BRIGHTON RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152331707",
            "telephone_number": "412-321-1648",
            "fax_number": "412-321-4216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITRE GASTROENTEROLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MITRE",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "412-321-1648",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "MD032806L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009520810001",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1568734",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.