NPIMap

Organization Active NPI

Glade Run Medical Associates Inc

  • Orthopaedic Surgery Physician
  • Leechburg, PA
National Provider Identifier
1871921908
Registry record updated Mar 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
GLADE RUN MEDICAL ASSOCIATES INC
Practice address
116 Main St
Leechburg, PA 15656-1333
Phone
(724) 845-8479
Fax
(724) 845-7764
NPI assigned
Oct 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2014

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

Authorized official

Name
Mr. Patrick Burns
Title
Cfo & VP Finance
Phone
(724) 543-8618

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

116 Main St
Leechburg, PA 15656-1333

Mailing address

116 Main St
Leechburg, PA 15656-1333
Phone (724) 845-8479

Other names 1

  • MainStreet Center for Orthopedics Shoulder & Sports Medicine Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100806000006 PA Part B Supplier - Clinic/Group Practice 3577696897 Receives reassigned benefits from 40 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kittanning, PA; Sarver, PA; New Bethlehem, PA; Natrona Heights, PA

Other NPIs on the same Medicare enrollment 25

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

View all 25

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394409600000",
    "number": "1871921908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 MAIN ST",
            "city": "LEECHBURG",
            "state": "PA",
            "postal_code": "156561333",
            "telephone_number": "724-845-8479",
            "fax_number": "724-845-7764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 MAIN ST",
            "city": "LEECHBURG",
            "state": "PA",
            "postal_code": "156561333",
            "telephone_number": "724-845-8479",
            "fax_number": "724-845-7764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLADE RUN MEDICAL ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-29",
        "last_updated": "2014-03-10",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "CFO & VP FINANCE",
        "authorized_official_telephone_number": "724-543-8618",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MainStreet Center for Orthopedics Shoulder & Sports Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Leechburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; 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.