NPIMap

Organization Active NPI

Heritage Valley Medical Group, Inc.

Doing business as HVMG Primary Care - Crafton

  • Family Medicine Physician
  • Pittsburgh, PA
National Provider Identifier
1417518036
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HERITAGE VALLEY MEDICAL GROUP, INC.
Doing business as
HVMG Primary Care - Crafton
Practice address
100 Foster Ave Ste B
Pittsburgh, PA 15205-2317
Phone
(412) 262-4694
NPI assigned
Jun 25, 2019
Last updated
Jun 25, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
HERITAGE VALLEY MEDICAL GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

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

Authorized official

Name
Bryan J Randall
Title
Vice President & Cfo
Phone
(412) 749-7027

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

100 Foster Ave Ste B
Pittsburgh, PA 15205-2317

Mailing address

100 Foster Ave Ste B
Pittsburgh, PA 15205-2317
Phone (412) 262-4694

Other identifiers 1

IdentifierTypeStateIssuer
001565446MedicaidPA

Other names 1

  • HVMG Primary Care - Crafton Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heritage Valleymedical Group Inc92 organizations share this tax ID, including this one
Part of
Heritage Valleymedical Group Inc

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

100 Foster Ave
Ste B
Pittsburgh, PA 15205
Phone (412) 262-4694

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561420800000",
    "number": "1417518036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FOSTER AVE STE B",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152052317",
            "telephone_number": "412-262-4694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FOSTER AVE STE B",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152052317",
            "telephone_number": "412-262-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE VALLEY MEDICAL GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HERITAGE VALLEY MEDICAL GROUP, INC.",
        "enumeration_date": "2019-06-25",
        "last_updated": "2019-06-25",
        "status": "A",
        "authorized_official_last_name": "RANDALL",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT & CFO",
        "authorized_official_telephone_number": "412-749-7027"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001565446",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HVMG Primary Care - Crafton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 25, 2019; 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.