NPIMap

Individual provider Active NPI

Umberto Anthony Derienzo, MD

  • Family Medicine Physician
  • Charleroi, PA
National Provider Identifier
1427021674
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD053835L Issued in PA
Practice address
17 Arentzen Blvd
Charleroi, PA 15022-1085
Phone
(724) 483-3581
Fax
(724) 483-3483
NPI assigned
Feb 8, 2006
Last updated
Jul 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD053835L PA Primary

Addresses

Primary practice location

17 Arentzen Blvd
Charleroi, PA 15022-1085

Mailing address

701 Technology Dr Ste 150
Canonsburg, PA 15317-9531
Phone (412) 531-2902

Other identifiers 1

IdentifierTypeStateIssuer
0015317510003MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040309000244 PA Practitioner - Family Practice 7719875046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Temple University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

17 Arentzen Blvd
Suite 101
Charleroi, PA 15022-1085
Phone (724) 483-3581

2375 Greentree Rd
Carnegie, PA 15106-4203
Phone (412) 276-1560

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD053835LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Primary Care Physicians, Inc. Family Medicine CurrentSince Jan 1, 2019 Accepting new patients
Preferred Primary Care Physicians, Inc. Family Medicine Current Accepting new patients
Preferred Primary Care Physicians CurrentSince Jan 1, 2019 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Derienzo Family Practice, P.C. PastSince Mar 12, 2004 Accepting new patients

Locations

701 Technology Dr
Ste 150
Canonsburg, PA 15317
Phone (412) 531-2902

2375 Greentree Rd
Carnegie, PA 15106
Phone (412) 276-1560

17 Arentzen Blvd
Ste 101
Charleroi, PA 15022
Phone (724) 482-3581

1910 Cochran Rd
Ste 490
Pittsburgh, PA 15220

151 N Franklin St
Washington, PA 15301
Phone (412) 222-7240

Interoperability endpoints

  • Direct secure messaging: umbertoderienzomd@preferred.medentdirect.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1427021674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 TECHNOLOGY DR STE 150",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153179531",
            "telephone_number": "412-531-2902",
            "fax_number": "412-531-2948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 ARENTZEN BLVD",
            "city": "CHARLEROI",
            "state": "PA",
            "postal_code": "150221085",
            "telephone_number": "724-483-3581",
            "fax_number": "724-483-3483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERIENZO",
        "first_name": "UMBERTO",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD053835L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015317510003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleroi, PA

Sources for this page

Verify at the official NPI Registry.