NPIMap

Organization Active NPI

Pittsburgh Kidney Care, LLC

  • Nephrology Physician
  • Pittsburgh, PA
National Provider Identifier
1851749386
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
C1-0001632 Issued in DE
Legal business name
PITTSBURGH KIDNEY CARE, LLC
Practice address
1401 Forbes Ave
350
Pittsburgh, PA 15219-5125
Phone
(412) 621-3631
Fax
(412) 687-2394
NPI assigned
May 25, 2016
Last updated
Jul 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Authorized official

Name
Michael Walczyk, MD
Title
Owner
Phone
(412) 621-3631

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X C1-0001632 DE Primary

Addresses

Primary practice location

1401 Forbes Ave
350
Pittsburgh, PA 15219-5125

Mailing address

1401 Forbes Ave
350
Pittsburgh, PA 15219-5125
Phone (412) 621-3631

Other identifiers 1

IdentifierTypeStateIssuer
103217936 0001MedicaidPA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564012800000",
    "number": "1851749386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 FORBES AVE",
            "address_2": "350",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152195125",
            "telephone_number": "412-621-3631",
            "fax_number": "412-687-2394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 FORBES AVE",
            "address_2": "350",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152195125",
            "telephone_number": "412-621-3631",
            "fax_number": "412-687-2394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PITTSBURGH KIDNEY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-25",
        "last_updated": "2019-07-25",
        "status": "A",
        "authorized_official_last_name": "WALCZYK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "412-621-3631",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "DE",
            "license": "C1-0001632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103217936 0001",
            "state": "PA"
        }
    ],
    "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 Jul 25, 2019; 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.