Organization Active NPI

Dr Edward Jew III Internal Medicine

  • Internal Medicine Physician
  • Jefferson Hills, PA
National Provider Identifier
1669931333
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DR EDWARD JEW III INTERNAL MEDICINE
Practice address
575 Coal Valley Rd Ste 502
Jefferson Hills, PA 15025-3729
Phone
(412) 267-6307
Fax
(412) 267-6309
NPI assigned
Mar 13, 2019
Last updated
Mar 13, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Authorized official

Name
Joan Catherine Grimm
Title
Manager
Phone
(412) 267-6307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

575 Coal Valley Rd Ste 502
Jefferson Hills, PA 15025-3729

Mailing address

575 Coal Valley Rd Ste 502
Jefferson Hills, PA 15025-3729
Phone (412) 267-6307

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190610001054 PA Part B Supplier - Clinic/Group Practice 9032442975 Receives reassigned benefits from 1 practitioner
Practice locations: Jefferson Hills, PA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2034985Dr Edward Jew III Internal Medicine575 Coal Valley Road, South Hills Med Office BLDG, Jefferson Hills, PA 15025Certificate of waiverJan 8, 2028

National Provider Directory

National Provider Directory

Locations

575 Coal Valley Rd
Ste 502
Jefferson Hls, PA 15025
Phone (412) 267-6307

Practitioners & affiliated clinicians

Practitioners 1

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": "1552435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552435200000",
    "number": "1669931333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 COAL VALLEY RD STE 502",
            "city": "JEFFERSON HILLS",
            "state": "PA",
            "postal_code": "150253729",
            "telephone_number": "412-267-6307",
            "fax_number": "412-267-6309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 COAL VALLEY RD STE 502",
            "city": "JEFFERSON HILLS",
            "state": "PA",
            "postal_code": "150253729",
            "telephone_number": "412-267-6307",
            "fax_number": "412-267-6309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR EDWARD JEW III INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-13",
        "last_updated": "2019-03-13",
        "status": "A",
        "authorized_official_last_name": "GRIMM",
        "authorized_official_first_name": "JOAN",
        "authorized_official_middle_name": "CATHERINE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "412-267-6307"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson Hills, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.