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.,

Doing business as

DeRienzo Family Practice

Practice address

17 Arentzen Blvd
Suite 101
Charleroi, PA 15022-1085

Phone

(724) 483-3581

Fax

(724) 483-3483

NPI assigned

Sep 29, 2010

Last updated

Mar 21, 2011By the provider in NPPES

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.NPI 1427021674

Title

President

Phone

(724) 483-3581

Specialties & licenses 1

Addresses

Other names 1

• DeRienzo Family Practice Doing business as

Part of

South Hills HLTH Ctr

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

Practitioners 1

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.

• Umberto Anthony Derienzo, MD

  • Family Medicine Physician
  • Charleroi, PA
  • NPI 1427021674
  Authorized official Same address or phone

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": "",
            "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. (McKnight Medical Equipment)
• Pinnacle Treatment Centers PA-VIII, LLC (Charleroi Treatment Services)
• Preferred Primary Care Physicians, Inc. (PPCP DeRienzo Family Practice)
• Perveen Ab Punjani, MD
• Benjamin H Reuter, ATC
• Julie Rippel, PT
• Rite Aid of Pennsylvania LLC (Rite Aid Pharmacy 04083)
• 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.