Organization Active NPI

Integrated Vascular and Interventional Radiology Associates of Pittsbu

  • Vascular & Interventional Radiology Physician
  • Cranberry Township, PA
National Provider Identifier
1407613409
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
INTEGRATED VASCULAR AND INTERVENTIONAL RADIOLOGY ASSOCIATES OF PITTSBU
Practice address
51 Dutilh Rd Ste 100
Cranberry Township, PA 16066-4148
Phone
(724) 201-2399
Fax
(724) 776-3864
NPI assigned
Mar 5, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Authorized official

Name
Ahmed Fadl, MDNPI 1144510603
Title
Physician Owner
Phone
(410) 419-0266

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
Vascular & Interventional Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0204X Primary

Addresses

Primary practice location

51 Dutilh Rd Ste 100
Cranberry Township, PA 16066-4148

Mailing address

51 Dutilh Rd Ste 100
Cranberry Township, PA 16066-4148

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240426001166 PA Part B Supplier - Clinic/Group Practice 5991145781 Receives reassigned benefits from 1 practitioner
Practice locations: Cranberry Township, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1709596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1407613409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 DUTILH RD STE 100",
            "city": "CRANBERRY TOWNSHIP",
            "state": "PA",
            "postal_code": "160664148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 DUTILH RD STE 100",
            "city": "CRANBERRY TOWNSHIP",
            "state": "PA",
            "postal_code": "160664148",
            "telephone_number": "724-201-2399",
            "fax_number": "724-776-3864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED VASCULAR AND INTERVENTIONAL RADIOLOGY ASSOCIATES OF PITTSBU",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-05",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "FADL",
        "authorized_official_first_name": "AHMED",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "410-419-0266",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranberry Township, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.