Individual provider Active NPI

Robert Whipple Bragdon, M.D.

  • Plastic Surgery Physician
  • Pittsburgh, PA
National Provider Identifier
1881649325
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MD015623E Issued in PA
Practice address
1050 Bower Hill Rd Ste 105
Pittsburgh, PA 15243-1866
Phone
(412) 572-6164
Fax
(412) 572-6156
NPI assigned
May 23, 2006
Last updated
Mar 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X MD015623E PA Primary

Addresses

Primary practice location

1050 Bower Hill Rd Ste 105
Pittsburgh, PA 15243-1866

Mailing address

1000 Bower Hill Road
St Clair Hospital - Affiliate Billing - Pamalyn
Pittsburgh, PA 15243-1873
Phone (412) 924-2548

Other practice location 1

3928 Washington Road
Suite 270
McMurray, PA 15317-2593
Phone (412) 572-6164

Other identifiers 2

IdentifierTypeStateIssuer
0007217910003MedicaidPA
P00334981OtherRR MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Pamalyn.Patnesky@stclair.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041229000754 PA Practitioner - Plastic and Reconstructive SurgeryPractitioner - Physical Medicine and Rehabilitation 9335107929 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD015623EPAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Clair Medical Services Inc CurrentSince Feb 1, 2018 Accepting new patients
St Clair Medical Services, Inc. Current Accepting new patients
St Clair Medical Services Inc CurrentSince Feb 1, 2018 Accepting new patients
Plastic Surgical Associates Plastic Surgery Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

3928 Washington Rd
Ste 270
McMurray, PA 15317
Phone (412) 429-8840

1000 Bower Hill Rd
Pittsburgh, PA 15243
Phone (412) 344-6600

1050 Bower Hill Rd
Ste 101
Pittsburgh, PA 15243
Phone (412) 343-1770

1050 Bower Hill Rd
Ste 105
Pittsburgh, PA 15243
Phone (412) 572-6194

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1881649325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 BOWER HILL ROAD",
            "address_2": "ST CLAIR HOSPITAL - AFFILIATE BILLING - PAMALYN",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152431873",
            "telephone_number": "412-924-2548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 BOWER HILL RD STE 105",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152431866",
            "telephone_number": "412-572-6164",
            "fax_number": "412-572-6156"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3928 Washington Road",
            "address_2": "Suite 270",
            "address_purpose": "LOCATION",
            "city": "McMurray",
            "state": "PA",
            "postal_code": "153172593",
            "country_code": "US",
            "telephone_number": "412-572-6164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAGDON",
        "first_name": "ROBERT",
        "middle_name": "WHIPPLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "PA",
            "license": "MD015623E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007217910003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00334981",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Pamalyn.Patnesky@stclair.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Pamalyn.Patne4sky@stclair.org",
            "address_1": "1050 Bower Hill Rd Ste 105",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152431866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.