NPIMap

Organization Active NPI

Primary Care Health Services, Inc.

Doing business as Alma Illery Medical Center

  • Federally Qualified Health Center (FQHC)
  • Pittsburgh, PA
National Provider Identifier
1487724084
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PRIMARY CARE HEALTH SERVICES, INC.
Doing business as
Alma Illery Medical Center
Practice address
7227 Hamilton Ave
Pittsburgh, PA 15208-1814
Phone
(412) 244-4700
Fax
(412) 244-4992
NPI assigned
Nov 9, 2006
Last updated
Sep 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Authorized official

Name
Wilford A. Payne
Title
Executive Director
Phone
(412) 244-4700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

7227 Hamilton Ave
Pittsburgh, PA 15208-1814

Mailing address

7227 Hamilton Ave
Pittsburgh, PA 15208-1814
Phone (412) 244-4700

Other names 1

  • Alma Illery Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100910000273 PA Part A Provider - Federally Qualified Health Center (FQHC) 7012825722 Practice locations: Pittsburgh, PA
O20110111000808 PA Part B Supplier - Clinic/Group Practice 7012825722 Receives reassigned benefits from 60 practitioners
1 other NPI on this enrollment
Practice locations: Pittsburgh, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487724084. Details of each certification follow.

Federally qualified health center certification: CCN 391810

Legal name
PRIMARY CARE HEALTH SERVICES, INC.
Doing business as
ALMA ILERY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 1, 1991
Last certification
Nov 1, 1991
Ownership / control type
Non-profit – other
Organization structure
CorporationNon-profit
Incorporated
Mar 1, 1977 in PA
Enrollment address
7227 Hamilton Ave
Pittsburgh, PA 15208-1814

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ronald Thornhill Individual Corporate Director Sep 27, 2010
Tawnya R. Farris Individual Corporate Director Sep 27, 2010
Carolyn Vera Callahan Individual Corporate Director Sep 27, 2010
John Hollis Individual W-2 Managing EmployeeCoo/ Finance Director Sep 1, 2019
Operational/Managerial ControlCoo/ Finance Director Sep 1, 2019
Judith Ginyard Individual Corporate Director Sep 27, 2010
Lea Blumenfeld Individual Corporate Director Feb 19, 2019
Jerome E Gloster Individual Corporate OfficerCeo Apr 1, 2019
W-2 Managing EmployeeCeo Apr 1, 2019
James Williams Individual Corporate Director Sep 27, 2010
Richard M. Adams Individual Corporate Director Nov 29, 2010
Eric Younkins Individual Corporate Director Apr 1, 2014

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 60

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317254400000",
    "number": "1487724084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 HAMILTON AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152081814",
            "telephone_number": "412-244-4700",
            "fax_number": "412-244-4992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7227 HAMILTON AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152081814",
            "telephone_number": "412-244-4700",
            "fax_number": "412-244-4992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2011-09-29",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "WILFORD",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "412-244-4700"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alma Illery Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.