NPIMap

Organization Active NPI

St. Clair Medical Services Inc.

Doing business as St. Clair Medical Group Internal Medicine

  • Internal Medicine Physician
  • Bethel Park, PA
National Provider Identifier
1861940082
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ST. CLAIR MEDICAL SERVICES INC.
Doing business as
St. Clair Medical Group Internal Medicine
Practice address
2000 Oxford Dr Ste 420
Bethel Park, PA 15102-1841
Phone
(412) 279-5372
Fax
(412) 279-5378
NPI assigned
Sep 16, 2016
Last updated
Oct 5, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. CLAIR HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Authorized official

Name
Pamalyn Patnesky
Title
Credentialing
Phone
(412) 942-2548

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 450501 PA
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2000 Oxford Dr Ste 420
Bethel Park, PA 15102-1841

Mailing address

1000 Bower Hill Rd
St Clair Hospital - Affiliate Billing - Pamalyn
Pittsburgh, PA 15243-1873
Phone (412) 942-2548

Other names 2

  • St. Clair Medical Group Internal Medicine Doing business as
  • Gobao Internal Medicine Former legal business name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Pamalyn.Patnesky@stclair.org Health Information Exchange (HIE)
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040301000889 PA Part B Supplier - Clinic/Group Practice 4183511553 Receives reassigned benefits from 394 practitioners
37 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pittsburgh, PA; Washington, PA; Bethel Park, PA; Bridgeville, PA; McKees Rocks, PA; McMurray, PA

Other NPIs on the same Medicare enrollment 37

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 37

National Provider Directory

National Provider Directory
Tax ID family
Elizabeth Eelkena MD24 organizations share this tax ID, including this one
Part of
St Clair Memorial Hosp

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1473984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1861940082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 BOWER HILL RD",
            "address_2": "ST CLAIR HOSPITAL - AFFILIATE BILLING - PAMALYN",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152431873",
            "telephone_number": "412-942-2548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 OXFORD DR STE 420",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "151021841",
            "telephone_number": "412-279-5372",
            "fax_number": "412-279-5378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CLAIR MEDICAL SERVICES INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. CLAIR HOSPITAL",
        "enumeration_date": "2016-09-16",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "PATNESKY",
        "authorized_official_first_name": "PAMALYN",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "412-942-2548"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "450501",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Pamalyn.Patnesky@stclair.org",
            "affiliation": "N",
            "endpointDescription": "HIE Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Pamalyn.Patnesky@stclair.org",
            "address_1": "2000 Oxford Dr Ste 420",
            "city": "Bethel Park",
            "state": "PA",
            "country_code": "US",
            "postal_code": "151021841",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "St. Clair Medical Group Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gobao Internal Medicine",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Bethel Park, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.