Active NPI
Laurel Ridge Surgical Associates, Inc.
- Surgery Physician
- Uniontown, PA
National Provider Identifier
1699862847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0010549730006 | Medicaid | PA | |
| 1395403 | Other | PA | UMWA |
| 103737 | Other | PA | UPMC |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Surgery Physician
- Uniontown, PA
- NPI 1679662373
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.