Sewickley Valley Rheumatology LLC
Organization Active NPI Rheumatology Physician · Ambridge, PA
NPI 1679638985 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1679638985
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rheumatology Physician 207RR0500X
- License
- MD049189L (PA)
- Legal business name
- SEWICKLEY VALLEY RHEUMATOLOGY LLC
- Practice address
- 1196 Merchant Street
Ambridge, PA 15003-2335 - Phone
- (724) 266-2447
- Fax
- (724) 266-2920
- NPI assigned
- Dec 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Geri L Bacu, MD
- Title
- Sole Proprietor
- Phone
- (724) 266-2447
Practitioners 1
-
Geri Lynn Bacu, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041115000483 | PA | Part B Supplier - Clinic/Group Practice | 0446214092 |
Receives reassigned benefits from 1 practitioner Practice locations: Ambridge, PA |
National Provider Directory
Locations
1196 Merchant St
Ambridge, PA 15003
Phone (724) 266-2447
426 Adams St
Ste 3
Rochester, PA 15074
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician |
207RR0500X | MD049189L | PA | Yes |
Addresses
Primary practice location
1196 Merchant Street
Ambridge, PA 15003-2335
Mailing address
1196 Merchant Street
Ambridge, PA 15003-2335
Phone (724) 266-2447
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1633767 | Other | PA | BLUE SHIELD |
Other providers in Ambridge, PA
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- Alethea Athena Rivera-Molina
- Lucinda Safran
- Richard A Schollaert
- Elizabeth Ann Shull
- Skin Mind Health
- Jocelyn Snyder
- Rachel A Snyder
- Deborah Ann Somuk-Atsidis
All providers in Ambridge, PA · Rheumatology Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.