Active NPI
Premier Medical Associates, PC
- Diagnostic Radiology Physician
- Monroeville, PA
National Provider Identifier
1407030141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- PREMIER MEDICAL ASSOCIATES, PC
- Practice address
- 3824 Northern Pike
Monroeville, PA 15146-2141 - Phone
- (412) 457-0175
- Fax
- (412) 547-0179
- NPI assigned
- Dec 18, 2007
- Organization subpart
- Yes
- Parent organization
- PREMIER MEDICAL ASSOCIATES, PC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mark Derubeis
- Title
- Ceo
- Phone
- (412) 457-0060
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
3824 Northern Pike
Monroeville, PA 15146-2141
Mailing address
3824 Northern Pike
Suite 200
Monroeville, PA 15146-2141
Phone (412) 457-0060
Other names 1
- Premier Medical Radiology
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031119000222 | PA | Part B Supplier - Clinic/Group Practice | 9830003235 |
Receives reassigned benefits from 191 practitioners 16 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Monroeville, PA; Somerset, PA; Pittsburgh, PA; North Versailles, PA; Irwin, PA; Greensburg, PA |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Internal Medicine Physician
- Monroeville, PA
- NPI 1447281092
O20031119000222
National Provider Directory
National Provider Directory- Part of
- Premier Medical Assocs PC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197936000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1197936000000",
"number": "1407030141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3824 NORTHERN PIKE",
"address_2": "SUITE 200",
"city": "MONROEVILLE",
"state": "PA",
"postal_code": "151462141",
"telephone_number": "412-457-0060",
"fax_number": "412-457-0092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3824 NORTHERN PIKE",
"city": "MONROEVILLE",
"state": "PA",
"postal_code": "151462141",
"telephone_number": "412-457-0175",
"fax_number": "412-547-0179"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PREMIER MEDICAL ASSOCIATES, PC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PREMIER MEDICAL ASSOCIATES, PC",
"enumeration_date": "2007-12-18",
"last_updated": "2007-12-18",
"status": "A",
"authorized_official_last_name": "DERUBEIS",
"authorized_official_first_name": "MARK",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "412-457-0060"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Premier Medical Radiology",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Monroeville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; 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.