Organization Active NPI

Laurel Ridge Surgical Associates, Inc.

  • Surgery Physician
  • Uniontown, PA
National Provider Identifier
1699862847
Registry record updated Oct 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
LAUREL RIDGE SURGICAL ASSOCIATES, INC.
Practice address
196 W Main St
Uniontown, PA 15401-5537
Phone
(724) 439-1020
Fax
(724) 434-5485
NPI assigned
Oct 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2008

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

Authorized official

Name
Dr. Michael J Reilly, M.D.
Title
President
Phone
(724) 439-1020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

196 W Main St
Uniontown, PA 15401-5537

Mailing address

196 W Main St
Uniontown, PA 15401-5537
Phone (724) 439-1020

Other identifiers 3

IdentifierTypeStateIssuer
0010549730006MedicaidPA
1395403OtherPAUMWA
103737OtherPAUPMC

National Provider Directory

National Provider Directory

Locations

205 Easy St
Ste 202
Uniontown, PA 15401
Phone (412) 439-1020

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224720000000",
    "number": "1699862847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 W MAIN ST",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154015537",
            "telephone_number": "724-439-1020",
            "fax_number": "724-434-5485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 W MAIN ST",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154015537",
            "telephone_number": "724-439-1020",
            "fax_number": "724-434-5485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL RIDGE SURGICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2008-10-23",
        "status": "A",
        "authorized_official_last_name": "REILLY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "724-439-1020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010549730006",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "1395403",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC",
            "identifier": "103737",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Uniontown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; 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.