NPIMap

Organization Active NPI

Upmc Community Medicine Inc

  • Family Medicine Physician
  • Hermitage, PA
National Provider Identifier
1962538017
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UPMC COMMUNITY MEDICINE INC
Practice address
705 Brookshire Dr
Suite 1
Hermitage, PA 16148-4513
Phone
(724) 346-3116
NPI assigned
Feb 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mark Ehalt
Title
Director
Phone
(412) 647-0943

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

705 Brookshire Dr
Suite 1
Hermitage, PA 16148-4513

Mailing address

705 Brookshire Dr
Suite 1
Hermitage, PA 16148-4513
Phone (724) 346-3116

Other names 1

  • Petrucci Family Healthcare UPMC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040217000388 PA Part B Supplier - Clinic/Group Practice 2062318975 Receives reassigned benefits from 1,494 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
University Family Pract200 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

Locations

705 Brookshire Dr
Ste 1
Hermitage, PA 16148
Phone (724) 346-3116

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1172361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962538017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 BROOKSHIRE DR",
            "address_2": "SUITE 1",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "161484513",
            "telephone_number": "724-346-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 BROOKSHIRE DR",
            "address_2": "SUITE 1",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "161484513",
            "telephone_number": "724-346-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPMC COMMUNITY MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EHALT",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "412-647-0943"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Petrucci Family Healthcare UPMC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hermitage, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.