NPIMap

Organization Active NPI

Heritage Valley Medical Group, Inc.

Doing business as HVMG Fifth Avenue Medical

  • Family Medicine Physician
  • Coraopolis, PA
National Provider Identifier
1871745455
Registry record updated Jun 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HERITAGE VALLEY MEDICAL GROUP, INC.
Doing business as
HVMG Fifth Avenue Medical
Practice address
1101 5TH Ave
Suite 202
Coraopolis, PA 15108-1577
Phone
(412) 269-0899
Fax
(412) 269-1462
NPI assigned
Oct 15, 2008
Last updated
Jun 29, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2012

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

Authorized official

Name
Norman F. Mitry
Title
President & Ceo
Phone
(724) 773-4776

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1101 5TH Ave
Suite 202
Coraopolis, PA 15108-1577

Mailing address

1101 5TH Ave
Suite 202
Coraopolis, PA 15108-1577
Phone (412) 269-0899

Other identifiers 2

IdentifierTypeStateIssuer
0014950830029MedicaidPA
2297465MedicaidOH

Other names 1

  • HVMG Fifth Avenue Medical Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heritage Valleymedical Group Inc92 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

Locations

1101 5th Ave
Ste 202
Coraopolis, PA 15108
Phone (412) 269-0899

NPI Registry JSON

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

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340928000000",
    "number": "1871745455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 5TH AVE",
            "address_2": "SUITE 202",
            "city": "CORAOPOLIS",
            "state": "PA",
            "postal_code": "151081577",
            "telephone_number": "412-269-0899",
            "fax_number": "412-269-1462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 5TH AVE",
            "address_2": "SUITE 202",
            "city": "CORAOPOLIS",
            "state": "PA",
            "postal_code": "151081577",
            "telephone_number": "412-269-0899",
            "fax_number": "412-269-1462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE VALLEY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-15",
        "last_updated": "2012-06-29",
        "status": "A",
        "authorized_official_last_name": "MITRY",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "724-773-4776"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014950830029",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2297465",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HVMG Fifth Avenue Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coraopolis, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; 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.