NPIMap

Organization Active NPI

Pinnacle Health Medical Services

Doing business as PinnacleHealth Dermatology Associates

  • Dermatology Physician
  • Mechanicsburg, PA
National Provider Identifier
1386079614
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
PINNACLE HEALTH MEDICAL SERVICES
Doing business as
PinnacleHealth Dermatology Associates
Practice address
21 Waterford Dr
Mechanicsburg, PA 17050-8268
Phone
(717) 591-3630
Fax
(717) 591-3631
NPI assigned
Sep 5, 2013
Last updated
Sep 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Authorized official

Name
William H Pugh
Title
Senior VP
Phone
(717) 231-8245

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA
Dermatology Physician 207N00000X PA Primary

Addresses

Primary practice location

21 Waterford Dr
Mechanicsburg, PA 17050-8268

Mailing address

409 S 2ND St
Suite 2F
Harrisburg, PA 17104-1612

Other identifiers 1

IdentifierTypeStateIssuer
100766676 0064MedicaidPA

Other names 1

  • PinnacleHealth Dermatology Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040407000180 PA Part B Supplier - Clinic/Group Practice 7618960493 Receives reassigned benefits from 2,171 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1378339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473206400000",
    "number": "1386079614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S 2ND ST",
            "address_2": "SUITE 2F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WATERFORD DR",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170508268",
            "telephone_number": "717-591-3630",
            "fax_number": "717-591-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE HEALTH MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-05",
        "last_updated": "2016-09-07",
        "status": "A",
        "authorized_official_last_name": "PUGH",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "SENIOR VP",
        "authorized_official_telephone_number": "717-231-8245"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100766676  0064",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PinnacleHealth Dermatology Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mechanicsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.