Active NPI
Maryjo A Houston, MD
- Family Medicine Physician
- Pittsburgh, PA
National Provider Identifier
1780625087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD036534E
- Practice address
- 310 Rodi Rd
Suite 100
Pittsburgh, PA 15235-3318 - Phone
- (412) 242-0777
- Fax
- (412) 242-5174
- NPI assigned
- Jun 9, 2006
- Reactivated
- Feb 11, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD036534E | PA | Primary |
Addresses
Primary practice location
310 Rodi Rd
Suite 100
Pittsburgh, PA 15235-3318
Mailing address
3824 Northern Pike
Suite 700
Monroeville, PA 15146-2141
Phone (412) 457-0060
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 080172837 | Other | RAILROAD MEDICARE | |
| P000250 | Other | GATEWAY HEALTH PLAN | |
| 001123088 | Medicaid | PA | |
| 133764 | Other | BLUE SHIELD | |
| 205766 | Other | UPMC HEALTH PLAN | |
| 4070665 | Other | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD036534E | PA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581379200000",
"number": "1780625087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3824 NORTHERN PIKE",
"address_2": "SUITE 700",
"city": "MONROEVILLE",
"state": "PA",
"postal_code": "151462141",
"telephone_number": "412-457-0060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 RODI RD",
"address_2": "SUITE 100",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152353318",
"telephone_number": "412-242-0777",
"fax_number": "412-242-5174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOUSTON",
"first_name": "MARYJO",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-09",
"last_updated": "2020-02-11",
"certification_date": "2020-02-11",
"deactivation_date": "2019-09-19",
"reactivation_date": "2020-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MD036534E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080172837",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY HEALTH PLAN",
"identifier": "P000250",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001123088",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "133764",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UPMC HEALTH PLAN",
"identifier": "205766",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4070665",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Pittsburgh, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.