NPIMap

Organization Active NPI

Upmc Community Medicine Inc

  • Family Medicine Physician
  • Ellwood City, PA
National Provider Identifier
1528510336
Registry record updated Oct 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UPMC COMMUNITY MEDICINE INC
Practice address
304 Evans Dr
Suite 201
Ellwood City, PA 16117-1477
Phone
(724) 752-8722
Fax
(724) 752-5508
NPI assigned
Oct 27, 2016
Last updated
Oct 27, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2016

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

Authorized official

Name
Mary Caldwell
Title
Sr. Manager
Phone
(412) 432-5846

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

304 Evans Dr
Suite 201
Ellwood City, PA 16117-1477

Mailing address

304 Evans Dr
Suite 201
Ellwood City, PA 16117-1477
Phone (724) 752-8722

Other identifiers 1

IdentifierTypeStateIssuer
042490OtherMC GROUP PTAN

Other names 1

  • Raymundo Medical Associates-UPMC Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040217000388 PA Part B Supplier - Clinic/Group Practice 2062318975 Receives reassigned benefits from 1,494 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Primecare Medical Assoc200 organizations share this tax ID, including this one

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

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1477526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477526400000",
    "number": "1528510336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 EVANS DR",
            "address_2": "SUITE 201",
            "city": "ELLWOOD CITY",
            "state": "PA",
            "postal_code": "161171477",
            "telephone_number": "724-752-8722",
            "fax_number": "724-752-5508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 EVANS DR",
            "address_2": "SUITE 201",
            "city": "ELLWOOD CITY",
            "state": "PA",
            "postal_code": "161171477",
            "telephone_number": "724-752-8722",
            "fax_number": "724-752-5508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPMC COMMUNITY MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-27",
        "last_updated": "2016-10-27",
        "status": "A",
        "authorized_official_last_name": "CALDWELL",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "SR. MANAGER",
        "authorized_official_telephone_number": "412-432-5846"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC GROUP PTAN",
            "identifier": "042490",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Raymundo Medical Associates-UPMC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ellwood City, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; 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.