Organization Active NPI

Upmc Community Medicine Inc

Doing business as UPMC Bedford Internal Medicine

  • Family Medicine Physician
  • Bedford, PA
National Provider Identifier
1639206402
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UPMC COMMUNITY MEDICINE INC
Doing business as
UPMC Bedford Internal Medicine
Practice address
118 S Anderson St
Suite 1
Bedford, PA 15522-1403
Phone
(814) 623-3474
NPI assigned
Feb 27, 2007
Last updated
Sep 5, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2007

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

Authorized official

Name
Mark Ehalt
Title
Director
Phone
(412) 647-0943

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

118 S Anderson St
Suite 1
Bedford, PA 15522-1403

Mailing address

118 S Anderson St
Suite 1
Bedford, PA 15522-1403
Phone (814) 623-3474

Other identifiers 1

IdentifierTypeStateIssuer
042568OtherPAHIGHMARK MEDICARE GROUP

Other names 1

  • UPMC Bedford Internal Medicine Doing business as

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

Locations

118 S Anderson St
Ste 1
Bedford, PA 15522
Phone (814) 623-2146

Practitioners & affiliated clinicians

Practitioners 6

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": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188950400000",
    "number": "1639206402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 S ANDERSON ST",
            "address_2": "SUITE 1",
            "city": "BEDFORD",
            "state": "PA",
            "postal_code": "155221403",
            "telephone_number": "814-623-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 S ANDERSON ST",
            "address_2": "SUITE 1",
            "city": "BEDFORD",
            "state": "PA",
            "postal_code": "155221403",
            "telephone_number": "814-623-3474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPMC COMMUNITY MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-09-05",
        "status": "A",
        "authorized_official_last_name": "EHALT",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "412-647-0943"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK MEDICARE GROUP",
            "identifier": "042568",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UPMC Bedford Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bedford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; 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.