Organization Active NPI

Neurologic Therapeutics of Pittsburgh, LLC

  • Neurology Physician
  • Monroeville, PA
National Provider Identifier
1831806934
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
NEUROLOGIC THERAPEUTICS OF PITTSBURGH, LLC
Practice address
2790 Mosside Blvd Ste 700
Monroeville, PA 15146-2761
Phone
(412) 527-1017
NPI assigned
Oct 31, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Authorized official

Name
Michael John Tometsko
Title
Owner
Phone
(412) 527-1017

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

2790 Mosside Blvd Ste 700
Monroeville, PA 15146-2761

Mailing address

4530 William Penn Hwy
PMB 108
Murrysville, PA 15668

Other identifiers 2

IdentifierTypeStateIssuer
1902954605MedicaidPA
1598761025MedicaidPA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1667174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667174400000",
    "number": "1831806934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 WILLIAM PENN HWY",
            "address_2": "PMB 108",
            "city": "MURRYSVILLE",
            "state": "PA",
            "postal_code": "15668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 MOSSIDE BLVD STE 700",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462761",
            "telephone_number": "412-527-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGIC THERAPEUTICS OF PITTSBURGH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-30",
        "status": "A",
        "authorized_official_last_name": "TOMETSKO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "412-527-1017"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902954605",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598761025",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.