Active NPI
Tibor Ketzan, M.D., P.C.
- Physical Medicine & Rehabilitation Physician
- Sewickley, PA
National Provider Identifier
1902925282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- MD021936E
- Legal business name
- TIBOR KETZAN, M.D., P.C.
- Practice address
- 720 Blackburn Rd
Sewickley, PA 15143-1459 - Phone
- (412) 749-7127
- NPI assigned
- Mar 28, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Tibor Ketzan, M.D.
- Title
- President
- Phone
- (412) 749-7127
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | MD021936E | PA | Primary |
Addresses
Primary practice location
720 Blackburn Rd
Sewickley, PA 15143-1459
Mailing address
720 Blackburn Rd
Sewickley, PA 15143-1459
Phone (412) 749-7127
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00994356 | Medicaid | PA | |
| 0024749 | Other | PA | US HEALTHCARE |
| 001953133 | Other | PA | HIGHMARK |
| 159417 | Other | PA | BLUE CROSS SHIELD HIGHMAR |
| 5803 | Other | PA | HEALTH AMERICA |
| 1007226 | Other | PA | GATEWAY |
National Provider Directory
National Provider DirectoryLocations
720 Blackburn Rd
Fl 3
Sewickley, PA 15143
Phone (412) 749-7127
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1457913600000",
"number": "1902925282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 BLACKBURN RD",
"city": "SEWICKLEY",
"state": "PA",
"postal_code": "151431459",
"telephone_number": "412-749-7127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 BLACKBURN RD",
"city": "SEWICKLEY",
"state": "PA",
"postal_code": "151431459",
"telephone_number": "412-749-7127"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TIBOR KETZAN, M.D., P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-28",
"last_updated": "2016-03-14",
"status": "A",
"authorized_official_last_name": "KETZAN",
"authorized_official_first_name": "TIBOR",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "412-749-7127",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation",
"state": "PA",
"license": "MD021936E",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00994356",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US HEALTHCARE",
"identifier": "0024749",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK",
"identifier": "001953133",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS SHIELD HIGHMAR",
"identifier": "159417",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH AMERICA",
"identifier": "5803",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY",
"identifier": "1007226",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sewickley, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.