NPIMap

Organization Active NPI

Prime Medical Group PCG1

  • Internal Medicine Physician
  • Clairton, PA
National Provider Identifier
1679712764
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PRIME MEDICAL GROUP PCG1
Practice address
1200 Brooks LN Ste 110
Clairton, PA 15025-3749
Phone
(412) 466-5502
Fax
(412) 469-8948
NPI assigned
Feb 12, 2009
Last updated
Nov 6, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Authorized official

Name
Denise Noel
Title
Director Provider Enrolment
Phone
(412) 330-5861

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X

Addresses

Primary practice location

1200 Brooks LN Ste 110
Clairton, PA 15025-3749

Mailing address

4 Allegheny Ctr FL 7
Pittsburgh, PA 15212-5255
Phone (412) 330-5861

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.ahn.org

National Provider Directory

National Provider Directory

Locations

1533 Broad Ave
Ste 1
Rostraver Township, PA 15012

1533 Broad Ave
Ste 100
Rostraver Township, PA 15012
Phone (724) 929-2260

1645 Rostraver Rd
Ste 200
Rostraver Township, PA 15012

1645 Rostraver Rd
Ste 202
Rostraver Township, PA 15012
Phone (724) 929-2260

Practitioners & affiliated clinicians

Practitioners 11

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": "1234396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604620800000",
    "number": "1679712764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ALLEGHENY CTR FL 7",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152125255",
            "telephone_number": "412-330-5861",
            "fax_number": "412-330-5844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 BROOKS LN STE 110",
            "city": "CLAIRTON",
            "state": "PA",
            "postal_code": "150253749",
            "telephone_number": "412-466-5502",
            "fax_number": "412-469-8948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME MEDICAL GROUP PCG1",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-12",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A",
        "authorized_official_last_name": "NOEL",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "DIRECTOR PROVIDER ENROLMENT",
        "authorized_official_telephone_number": "412-330-5861"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.ahn.org",
            "affiliation": "N",
            "address_1": "1200 Brooks Ln Ste 110",
            "city": "Clairton",
            "state": "PA",
            "country_code": "US",
            "postal_code": "150253749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clairton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.