Organization Active NPI

Ambulatory Surgery Center at the Jefferson Pain & Rehab Center

  • Ambulatory Surgical Clinic/Center
  • Pittsburgh, PA
National Provider Identifier
1558613067
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
AMBULATORY SURGERY CENTER AT THE JEFFERSON PAIN & REHAB CENTER
Practice address
4735 Clairton Blvd
Pittsburgh, PA 15236-2115
Phone
(412) 885-5400
Fax
(412) 885-1773
NPI assigned
Oct 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Authorized official

Name
Dr. John Keun-Sang Lee, M.D.
Title
Medical Director/President
Phone
(412) 885-5400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X PA Primary

Addresses

Primary practice location

4735 Clairton Blvd
Pittsburgh, PA 15236-2115

Mailing address

4735 Clairton Blvd
Pittsburgh, PA 15236-2115
Phone (412) 885-5400

Other identifiers 1

IdentifierTypeStateIssuer
0016772370001MedicaidPA

National Provider Directory

National Provider Directory

Locations

3900 Industrial Park Dr
Ste 8
Altoona, PA 16602

129 Simpson Rd
Ste 105
Brownsville, PA 15417
Phone (724) 785-4221

1741 Grand Blvd
Monessen, PA 15062
Phone (724) 684-8476

100 Stoops Dr
Ste 270
Monongahela, PA 15063
Phone (724) 489-9550

4735 Clairton Blvd
Pittsburgh, PA 15236
Phone (412) 884-5400

625 Cherry Tree Ln
Ste 102
Uniontown, PA 15401
Phone (724) 438-4300

NPI Registry JSON

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421712000000",
    "number": "1558613067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4735 CLAIRTON BLVD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152362115",
            "telephone_number": "412-885-5400",
            "fax_number": "412-885-1773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 CLAIRTON BLVD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152362115",
            "telephone_number": "412-885-5400",
            "fax_number": "412-885-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBULATORY SURGERY CENTER AT THE JEFFERSON PAIN & REHAB CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-08",
        "last_updated": "2015-01-20",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "KEUN-SANG",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/PRESIDENT",
        "authorized_official_telephone_number": "412-885-5400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016772370001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jan 20, 2015; 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.