Individual provider Active NPI

Gregory Andrew Bohatch, D.M.D.

  • General Practice Dentistry
  • Pittsburgh, PA
National Provider Identifier
1629174651
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS027408L Issued in PA
Practice address
509 Long Rd
Pittsburgh, PA 15235-4330
Phone
(412) 241-1888
Fax
(412) 241-2057
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS027408L PA Primary

Addresses

Primary practice location

509 Long Rd
Pittsburgh, PA 15235-4330

Mailing address

509 Long Rd
Pittsburgh, PA 15235-4330
Phone (412) 241-1888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160425000758 PA Order and Referring Only - DentistPractitioner - Dentist 5092014118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS027408LPAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629174651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 LONG RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152354330",
            "telephone_number": "412-241-1888",
            "fax_number": "412-241-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 LONG RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152354330",
            "telephone_number": "412-241-1888",
            "fax_number": "412-241-2057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHATCH",
        "first_name": "GREGORY",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS027408L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.