NPIMap

Organization Active NPI

Pefha Health & Wellness Center

  • Family Medicine Physician
  • Pittsburgh, PA
National Provider Identifier
1578616637
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD-72372L Issued in PA
Legal business name
PEFHA HEALTH & WELLNESS CENTER
Practice address
10 Duff Rd Ste 103
Pittsburgh, PA 15235-3261
Phone
(412) 241-4104
Fax
(412) 241-9567
NPI assigned
Jan 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Authorized official

Name
Dr. Yvette Broadnax, MDNPI 1922014000
Title
President
Phone
(412) 241-4104

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MD-72372L PA Primary

Addresses

Primary practice location

10 Duff Rd Ste 103
Pittsburgh, PA 15235-3261

Mailing address

10 Duff Rd Ste 103
Pittsburgh, PA 15235-3261
Phone (412) 241-4104

Other practice location 1

8989 Frankstown Rd
Pittsburgh, PA 15235-1429
Phone (412) 241-4104

Other identifiers 1

IdentifierTypeStateIssuer
018405050003MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041108000780 PA Part B Supplier - Clinic/Group Practice 6608839980 Receives reassigned benefits from 1 practitioner
Practice locations: Pittsburgh, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 85

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 85

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667433600000",
    "number": "1578616637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DUFF RD STE 103",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152353261",
            "telephone_number": "412-241-4104",
            "fax_number": "412-241-9567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 DUFF RD STE 103",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152353261",
            "telephone_number": "412-241-4104",
            "fax_number": "412-241-9567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8989 Frankstown Rd",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152351429",
            "country_code": "US",
            "telephone_number": "412-241-4104",
            "fax_number": "412-241-9567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PEFHA HEALTH & WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A",
        "authorized_official_last_name": "BROADNAX",
        "authorized_official_first_name": "YVETTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "412-241-4104",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD-72372L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018405050003",
            "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 Nov 3, 2022; 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.