NPIMap

Organization Active NPI

Allegheny Clinic

  • Surgery Physician
  • Canonsburg, PA
National Provider Identifier
1700212701
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
ALLEGHENY CLINIC
Practice address
242 E McMurray Rd
Canonsburg, PA 15317-2963
Phone
(724) 942-3202
Fax
(724) 942-4377
NPI assigned
Sep 23, 2013
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 Enrollment
Phone
(412) 330-5861

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X PA Primary

Addresses

Primary practice location

242 E McMurray Rd
Canonsburg, PA 15317-2963

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
100731714MedicaidPA

Other names 1

  • Waterdam Surgical Associates Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.ahn.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040310000602 PA Part B Supplier - Clinic/Group Practice 5395649586 Receives reassigned benefits from 3,418 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1379894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604620800000",
    "number": "1700212701",
    "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": "242 E MCMURRAY RD",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153172963",
            "telephone_number": "724-942-3202",
            "fax_number": "724-942-4377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEGHENY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-23",
        "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 ENROLLMENT",
        "authorized_official_telephone_number": "412-330-5861"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100731714",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.ahn.org",
            "affiliation": "N",
            "address_1": "242 E McMurray Rd",
            "city": "Canonsburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "153172963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Waterdam Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Waterdam Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canonsburg, 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.