Individual provider Active NPI

Beverly Jean Gruarin, D.P.M.

  • Podiatrist
  • Pittsburgh, PA
National Provider Identifier
1912122920
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC002856L Issued in PA
Practice address
4732 Liberty Ave
Pittsburgh, PA 15224-2051
Phone
(412) 681-8840
Fax
(412) 681-9073
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC002856L PA Primary

Addresses

Primary practice location

4732 Liberty Ave
Pittsburgh, PA 15224-2051

Mailing address

4732 Liberty Ave
Pittsburgh, PA 15224-2051
Phone (412) 681-8840

Other identifiers 1

IdentifierTypeStateIssuer
1054507MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141211000121 PA Practitioner - Podiatry 2264754787 Practice locations: Monroeville, PA; Pittsburgh, PA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4732 Liberty Ave
Pittsburgh, PA 15224-2051
Phone (412) 681-8840

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue133
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204156800000",
    "number": "1912122920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4732 LIBERTY AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152242051",
            "telephone_number": "412-681-8840",
            "fax_number": "412-681-9073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4732 LIBERTY AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152242051",
            "telephone_number": "412-681-8840",
            "fax_number": "412-681-9073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUARIN",
        "first_name": "BEVERLY",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2008-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC002856L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1054507",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.