NPIMap

Jefferson Regional Medical Center

Organization Active NPI Psychiatry Physician · Pittsburgh, PA

NPI 1891763249 · NPPES record last updated Nov 9, 2020

Key facts

NPI
1891763249
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatry Physician 2084P0800X
Legal business name
JEFFERSON REGIONAL MEDICAL CENTER
Practice address
810 Clairton Blvd Ste 500600
Pittsburgh, PA 15236-5505
Phone
(412) 650-1100
Fax
(412) 650-1101
NPI assigned
Mar 10, 2006
Organization subpart
No

Authorized official

Name
Denise Noel
Title
Director Provider Enrollment
Phone
(412) 330-5861

Other NPIs with the same Medicare PAC ID 3

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

Practitioners 120

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 120

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040917000518 PA Part B Supplier - Clinic/Group Practice 2163336017 Receives reassigned benefits from 92 practitioners
Practice locations: West Mifflin, PA; South Park, PA; Pleasant Hills, PA; Pittsburgh, PA; Carnegie, PA; Muse, PA; Monroeville, PA; Monaca, PA…

National Provider Directory

Locations

810 Clairton Blvd
Ste 500
Pittsburgh, PA 15236
Phone (412) 592-1470

810 Clairton Blvd
Ste 500600
Pittsburgh, PA 15236
Phone (412) 650-1100

4653 Clairton Blvd
Pittsburgh, PA 15236
Phone (412) 885-7500

404 Old Clairton Rd
Pleasant Hills, PA 15236
Phone (331) 725-4322

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor
Group: 193200000X MULTI-SPECIALTY GROUP		 101YP2500X
Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP		 103T00000X
Clinical Social Worker
Group: 193200000X MULTI-SPECIALTY GROUP		 1041C0700X
Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2084P0800X Yes

Addresses

Primary practice location

810 Clairton Blvd Ste 500600
Pittsburgh, PA 15236-5505

Mailing address

810 Clairton Blvd Ste 500600
Pittsburgh, PA 15236-5505
Phone (412) 650-1100

Other names

  • Jefferson Hospital Counseling Services Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.ahn.org

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 9, 2020.

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604880000000",
    "number": "1891763249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 CLAIRTON BLVD STE 500600",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152365505",
            "telephone_number": "412-650-1100",
            "fax_number": "412-650-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 CLAIRTON BLVD STE 500600",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152365505",
            "telephone_number": "412-650-1100",
            "fax_number": "412-650-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A",
        "authorized_official_last_name": "NOEL",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "DIRECTOR PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "412-330-5861"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.ahn.org",
            "affiliation": "N",
            "address_1": "810 Clairton Blvd Ste 500600",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152365505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Jefferson Hospital Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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All providers in Pittsburgh, PA · Psychiatry Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.