NPIMap

Organization Active NPI

Squirrel Hill Health Center

  • Federally Qualified Health Center (FQHC)
  • Pittsburgh, PA
National Provider Identifier
1891565446
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SQUIRREL HILL HEALTH CENTER
Practice address
100 S Jackson Ave FL 3
Pittsburgh, PA 15202-3428
Phone
(412) 422-7442
Fax
(412) 904-5025
NPI assigned
Jan 4, 2024
Organization subpart
Yes
Parent organization
SQUIRREL HILL HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Authorized official

Name
Amy Cohn
Title
Chief Financial Officer
Phone
(412) 680-3250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

100 S Jackson Ave FL 3
Pittsburgh, PA 15202-3428

Mailing address

PO Box 6327
Hermitage, PA 16148-0924
Phone (412) 422-7442

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240803000292 PA Part A Provider - Federally Qualified Health Center (FQHC) 2567473937 Practice locations: Pittsburgh, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891565446. Details of each certification follow.

Federally qualified health center certification: CCN D31007

Legal name
SQUIRREL HILL HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 26, 2024
Last certification
Jul 26, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
100 S Jackson Ave
Pittsburgh, PA 15202-3428

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Squirrel Hill Health Center4 organizations share this tax ID, including this one
Part of
Squirrel Hill Health Center

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ganga Baral Individual OtherPatient Jan 1, 2018
Elizabeth Hazlett Individual OtherPatient Jan 1, 2022
Amy Cohn Individual W-2 Managing EmployeeDirector Officer Jan 1, 2021
Jessica Ruffin Individual OtherCommunity Jan 1, 2023
Andrea R Fox Individual OtherExecutive Management Jan 1, 2006
Margaret Petruska Individual OtherChair Jan 1, 2022
George Eke Individual OtherPatient Jan 1, 2022
Thomas Albanesi Individual OtherTreasurer Jan 1, 2017
Susan Kalson Individual OtherExecutive Management Jan 1, 2006
Pat Siger Individual OtherChair Jan 1, 2016

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1704326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705881600000",
    "number": "1891565446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6327",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "161480924",
            "telephone_number": "412-422-7442",
            "fax_number": "412-904-5025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S JACKSON AVE FL 3",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152023428",
            "telephone_number": "412-422-7442",
            "fax_number": "412-904-5025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SQUIRREL HILL HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SQUIRREL HILL HEALTH CENTER",
        "enumeration_date": "2024-01-04",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A",
        "authorized_official_last_name": "COHN",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "412-680-3250"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.