NPIMap

Organization Active NPI

SMG/Santucci - Upmc - Shadyside

  • Non-Pharmacy Dispensing Site
  • Pittsburgh, PA
National Provider Identifier
1962543439
Registry record updated Aug 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
MD030965E Issued in PA
Legal business name
SMG/SANTUCCI - UPMC - SHADYSIDE
Practice address
580 S Aiken Ave
Shadyside Place BLDG Suite 300
Pittsburgh, PA 15232-1531
Phone
(412) 687-5040
NPI assigned
Feb 9, 2007
Last updated
Aug 2, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDVANTX, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 2, 2010

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

Authorized official

Name
Mr. Kenny Heine
Title
Director of Operations
Phone
(858) 625-2990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X MD030965E PA Primary

Addresses

Primary practice location

580 S Aiken Ave
Shadyside Place BLDG Suite 300
Pittsburgh, PA 15232-1531

Mailing address

5810 Nancy Ridge Dr
100
San Diego, CA 92121-2834
Phone (858) 625-2990

National Provider Directory

National Provider Directory
Tax ID family
Primecare Medical Assoc200 organizations share this tax ID, including this one
Part of
Medvantx Inc

Organizations with this tax ID in the same state 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280707200000",
    "number": "1962543439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5810 NANCY RIDGE DR",
            "address_2": "100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212834",
            "telephone_number": "858-625-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 S AIKEN AVE",
            "address_2": "SHADYSIDE PLACE BLDG SUITE 300",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152321531",
            "telephone_number": "412-687-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMG/SANTUCCI - UPMC - SHADYSIDE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2007-02-09",
        "last_updated": "2010-08-02",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "PA",
            "license": "MD030965E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.