Individual provider Active NPI

Steven Harris Untracht, M.D., PH.D., F.A.C.S

  • Surgery Physician
  • Johnstown, PA
National Provider Identifier
1477734812
Registry record updated Sep 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD053645L Issued in PA
Practice address
123 Tank Dr
Johnstown, PA 15904-3223
Phone
(814) 659-8459
Fax
(866) 824-5981
NPI assigned
Nov 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD053645L PA Primary

Addresses

Primary practice location

123 Tank Dr
Johnstown, PA 15904-3223

Mailing address

123 Tank Dr
Johnstown, PA 15904-3223
Phone (814) 659-8459

Other identifiers 1

IdentifierTypeStateIssuer
1267829MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD053645LPAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Care1 Urgent Care LLC Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284422400000",
    "number": "1477734812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 TANK DR",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043223",
            "telephone_number": "814-659-8459",
            "fax_number": "866-824-5981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 TANK DR",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043223",
            "telephone_number": "814-659-8459",
            "fax_number": "866-824-5981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNTRACHT",
        "first_name": "STEVEN",
        "middle_name": "HARRIS",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D., F.A.C.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-14",
        "last_updated": "2010-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD053645L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1267829",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; 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.