Organization Active NPI

Ipg Oral Surgery LLP

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Indiana, PA
National Provider Identifier
1730906454
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
Legal business name
IPG ORAL SURGERY LLP
Practice address
841 Hospital Rd Ste 3300
Indiana, PA 15701-3620
Phone
(888) 452-4762
NPI assigned
Sep 24, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Authorized official

Name
April L Miller
Title
Executive Director of Revenue Cycle
Phone
(724) 357-7009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193200000X MULTI-SPECIALTY GROUP 204E00000X Primary

Addresses

Primary practice location

841 Hospital Rd Ste 3300
Indiana, PA 15701-3620

Mailing address

640 Kolter Dr
Indiana, PA 15701-3570
Phone (724) 357-7333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250130004084 PA Part B Supplier - Clinic/Group Practice 6305375650 Receives reassigned benefits from 1 practitioner
Practice locations: Indiana, PA

National Provider Directory

National Provider Directory

Locations

841 Hospital Rd
Ste 3300
Indiana, PA 15701
Phone (724) 357-7490

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": "1727136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728345600000",
    "number": "1730906454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 KOLTER DR",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013570",
            "telephone_number": "724-357-7333",
            "fax_number": "724-357-7279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 HOSPITAL RD STE 3300",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013620",
            "telephone_number": "888-452-4762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IPG ORAL SURGERY LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-24",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "APRIL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "724-357-7009"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indiana, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.