Organization Active NPI

Premier Plastic Surgery, P.C.

  • Plastic Surgery Physician
  • Wexford, PA
National Provider Identifier
1760436349
Registry record updated Dec 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
PREMIER PLASTIC SURGERY, P.C.
Practice address
14000 Perry Highway
Suite 200
Wexford, PA 15090-8442
Phone
(724) 933-1800
Fax
(724) 933-1810
NPI assigned
May 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2015

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

Authorized official

Name
Dana Aulicino, MPM
Title
Director
Phone
(724) 933-1800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

14000 Perry Highway
Suite 200
Wexford, PA 15090-8442

Mailing address

14000 Perry Highway
Suite 200
Wexford, PA 15090-8442
Phone (724) 933-1800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040116000120 PA Part B Supplier - Clinic/Group Practice 7618878356 Receives reassigned benefits from 2 practitioners
Practice locations: Pittsburgh, PA; Wexford, PA

National Provider Directory

National Provider Directory

Locations

901 E Brady St
Ste 300
Butler, PA 16001
Phone (724) 933-1800

144 Emeryville Dr
Ste 110
Cranberry Twp, PA 16066
Phone (724) 776-2111

1614 Washington Rd
Ste 120
Pittsburgh, PA 15241

1614 Washington Rd
Ste 102
Pittsburgh, PA 15241

100 Siena Dr
Pittsburgh, PA 15241

100 Siena Dr
Ste 295
Pittsburgh, PA 15241

14000 Perry Hwy
Ste 200
Wexford, PA 15090
Phone (724) 776-2111

Practitioners & affiliated clinicians

Practitioners 5

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": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450396800000",
    "number": "1760436349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14000 PERRY HIGHWAY",
            "address_2": "SUITE 200",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150908442",
            "telephone_number": "724-933-1800",
            "fax_number": "724-933-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14000 PERRY HIGHWAY",
            "address_2": "SUITE 200",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150908442",
            "telephone_number": "724-933-1800",
            "fax_number": "724-933-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PLASTIC SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2015-12-18",
        "status": "A",
        "authorized_official_last_name": "AULICINO",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "724-933-1800",
        "authorized_official_credential": "MPM"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wexford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2015; 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.