Primary Care Group 12, Inc.,

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD053835L Issued in PA

Legal business name

PRIMARY CARE GROUP 12, INC.,

Practice address

17 Arentzen Blvd
Suite 101
Charleroi, PA 15022-1085

Phone

(724) 483-3581

Fax

(724) 483-3483

NPI assigned

Sep 29, 2010

Organization subpart

Yes

Parent organization

JEFFERSON REGIONAL MEDICAL CENTERAs reported in NPPES

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

Authorized official

Name

Umberto A. Derienzo, M.D.

Title

President

Phone

(724) 483-3581

Specialties & licenses 1

Addresses

Other names 1

• DeRienzo Family Practice Doing business as

Part of

South HLS HLTH Sys Neur

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Jefferson Regional Medical Center

  • General Acute Care Hospital
  • Clairton, PA
  • NPI 1578560504

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300665600000",
    "number": "1881903532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 ARENTZEN BLVD",
            "address_2": "SUITE 101",
            "city": "CHARLEROI",
            "state": "PA",
            "postal_code": "150221085",
            "telephone_number": "724-483-3581",
            "fax_number": "724-483-3483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 ARENTZEN BLVD",
            "address_2": "SUITE 101",
            "city": "CHARLEROI",
            "state": "PA",
            "postal_code": "150221085",
            "telephone_number": "724-483-3581",
            "fax_number": "724-483-3483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE GROUP 12, INC.,",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JEFFERSON REGIONAL MEDICAL CENTER",
        "enumeration_date": "2010-09-29",
        "last_updated": "2011-03-21",
        "status": "A",
        "authorized_official_last_name": "DERIENZO",
        "authorized_official_first_name": "UMBERTO",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "724-483-3581",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD053835L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeRienzo Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael James Perozzi, DPM
• Colleen Malena Petitto, RD, LDN, CDE
• Pieri, Inc.
• Pinnacle Treatment Centers PA-VIII, LLC
• Preferred Primary Care Physicians, Inc.
• Perveen Ab Punjani, MD
• Benjamin H Reuter, ATC
• Julie Rippel, PT
• Rite Aid of Pennsylvania LLC
• Kelsie Rohrbough, MS, NCC

• Family Medicine Physician in Charleroi, PA
• Providers in Charleroi, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2011; 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.