Shadyside Surgi-Center, Inc.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SHADYSIDE SURGI-CENTER, INC.

Practice address

5727 Centre Ave
Pittsburgh, PA 15206-3707

Phone

(412) 363-6626

Fax

(412) 363-7008

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Raymond A Capone Jr., M.D.

Title

Medical Director

Phone

(412) 363-6626

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Listed as

Shadyside Surgi CenterCCN 39C0001049

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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

• Avery C Capone, MD

  • Plastic Surgery Physician
  • Pittsburgh, PA
  • NPI 1114217643
  NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380153600000",
    "number": "1952408783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5727 CENTRE AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152063707",
            "telephone_number": "412-363-6626",
            "fax_number": "412-363-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5727 CENTRE AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152063707",
            "telephone_number": "412-363-6626",
            "fax_number": "412-363-7008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADYSIDE SURGI-CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-09-26",
        "status": "A",
        "authorized_official_last_name": "CAPONE",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "412-363-6626",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001506187002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK ID",
            "identifier": "0177",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shadyside Eye Associates. LLC
• Shadyside Nursing and Rehabilitation Center-Pittsburgh PA, LLC (ProMedica Skilled Nursing and Rehabilitation (Shadyside))
• Shadyside Optical Associates LLC
• Shadyside Psychological Services
• Shadyside SNF Healthcare LLC (Ivy Park Post Acute)
• Devon Shafer
• Debbie Ann Shaffer, LISW-S
• Edward Shaffer
• Elizabeth Joy Shaffer, OTR/L
• Gina Marie Shaffer, PA-C

• Ambulatory Surgical Clinic/Center in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Ambulatory Surgical Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.