NPIMap

Individual provider Active NPI

Jerome E Gloster, MD

  • Pediatrics Physician
  • Pittsburgh, PA
National Provider Identifier
1821057126
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD057254L Issued in PA
Practice address
816 Middle St
Pittsburgh, PA 15212-4915
Phone
(412) 321-4001
Fax
(412) 321-4063
NPI assigned
Mar 23, 2006
Last updated
Nov 17, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD057254L PA Primary

Addresses

Primary practice location

816 Middle St
Pittsburgh, PA 15212-4915

Mailing address

816 Middle St
Pittsburgh, PA 15212-4915
Phone (412) 321-4001

Other identifiers 1

IdentifierTypeStateIssuer
0015481130001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190702003001 PA Practitioner - Pediatric Medicine 5799019212 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Health Services, Inc. CurrentSince Nov 13, 2018 Accepting new patients
Primary Care Health Services, Inc. CurrentSince Jun 1, 2019 Accepting new patients
Primary Care Health Services Inc Past Accepting new patients

Locations

7225 Hamilton Ave
Pittsburgh, PA 15208
Phone (412) 244-4700

807 Wallace Ave
Wilkinsburg, PA 15221
Phone (412) 247-5216

Interoperability endpoints

  • Direct secure messaging: jerome.gloster@nschc.eclinicaldirectplus.com
  • Direct secure messaging: jgloster@pchspitt.medentdirect.com

Ownership & related parties

All facility ownership & control disclosures 10

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
East End Health CenterPittsburgh, PA, CCN 391946 Federally qualified health center Corporate Officer
W-2 Managing Employee		 Apr 1, 2019
Apr 1, 2019
Alma Ilery Medical CenterPittsburgh, PA, CCN 391810 Federally qualified health center Corporate Officer
W-2 Managing Employee		 Apr 1, 2019
Apr 1, 2019
Braddock Family Health CenterBraddock, PA, CCN 391915 Federally qualified health center Corporate Officer
W-2 Managing Employee		 Apr 1, 2019
Apr 1, 2019
Hazelwood Health CenterPittsburgh, PA, CCN 391917 Federally qualified health center Corporate Officer
W-2 Managing Employee		 Apr 1, 2019
Apr 1, 2019
Hill House Health CenterPittsburgh, PA, CCN 391918 Federally qualified health center Corporate Officer
W-2 Managing Employee		 Apr 1, 2019
Apr 1, 2019
Primary Care Health Services, Inc.Homestead, PA, CCN 391886 Federally qualified health center Corporate Director
W-2 Managing Employee		 Feb 19, 2019
Apr 1, 2019
Wilkinsburg Family Health CenterWilkinsburg, PA, CCN 391868 Federally qualified health center Corporate Director
W-2 Managing Employee		 Sep 1, 2018
Apr 1, 2019
Alma Illery Medical CenterPittsburgh, PA, CCN 391842 Federally qualified health center Corporate Officer
W-2 Managing Employee		 Apr 1, 2019
Apr 1, 2019
Primary Care Health Services, Inc.McKeesport, PA, CCN 391844 Federally qualified health center Corporate Officer
W-2 Managing Employee		 Apr 1, 2019
Apr 1, 2019
Absolute CarePittsburgh, PA, CCN D31019 Federally qualified health center Corporate Director Apr 1, 2018

Owned or controlled facilities with NPI records 10

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1821057126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 MIDDLE ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124915",
            "telephone_number": "412-321-4001",
            "fax_number": "412-321-4063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 MIDDLE ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124915",
            "telephone_number": "412-321-4001",
            "fax_number": "412-321-4063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOSTER",
        "first_name": "JEROME",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD057254L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015481130001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.